# Autogenous paneled femoral vein grafts for mycotic thoracic aortic aneurysms

## TL;DR

This paper introduces a new surgical technique using a patient's own femoral vein to repair rare aortic infections, showing promising safety and survival outcomes.

## Contribution

The study is the first to describe and compare autogenous femoral vein grafts with prosthetic grafts for mycotic thoracic aortic aneurysms.

## Key findings

- Patients receiving femoral vein grafts had a trend toward lower in-hospital and long-term mortality.
- Femoral vein graft patients were more likely to be discharged home compared to those with prosthetic grafts.
- No long-term complications were observed in the femoral vein graft group.

## Abstract

Mycotic thoracic aortic aneurysms (MTAAs) are rare. The most common management has been aortic resection, wide debridement, and in-line reconstruction using prosthetic grafts. We have used autogenous femoral vein (FV) for the repair of all MTAA in our institution since 2017. This is the initial description of this technique, and the first comparative study of autogenous vein compared with prosthetic for MTAAs.

This is a single-center retrospective cohort study of all patients with MTAA who underwent operative repair. Patients were assigned to the FV or prosthetic grafts cohorts. Perioperative and long-term outcomes were collected. Univariate logistic regression models were fitted to quantify the strength of differences between the cohorts.

Nineteen patients were included. The first 9 consecutive patients had prosthetic grafts, whereas the 10 subsequent patients were treated with FV grafts. Patients in the FV cohort were more likely to have positive intraoperative cultures (90% vs 33.3%; P = .02), receive intraoperative transfusions (10 vs 8 units; P = .08), and have a longer operation (629 vs 500 minutes; P = .07). There was a trend toward improved in-hospital (0 vs 33%; P = .09) and long-term mortality (10% vs 55.6%; P = .57) in the FV cohort. Patients in the FV cohort were more likely to be discharged home (90% vs 44.4%; P = .05).

Paneled autogenous FV repair is a durable and safe treatment for patients with MTAA. There were no in-hospital deaths in our series and there have been no long-term complications related to the vein graft repair.