What is the best way to manage composite graft endocarditis?
We have seen this problem in eight individuals among 218 Marfan patients undergoing aortic root replacement. We did successfully treat one patient with antibiotics alone, but found that reoperating with a second composite graft leads to continuing endocarditis. It is therefore mandatory that if reoperation is done, a homograft should be placed. We have had successful replacement of an infected composite graft using a homograft in three patients.
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