In situ replacement with equine pericardial roll grafts for ruptured infected aneurysms of the abdominal aorta

We describe surgical in situ replacement using an equine pericardial roll to treat ruptured infected abdominal aortic aneurysms (AAA) in two patients. A 78-year-old man diagnosed with ruptured infected (Bacteroides fragilis) AAA underwent in situ replacement of the abdominal aorta using a bifurcated equine pericardial roll graft with concomitant omentum flap wrapping. A 50-year-old man diagnosed with ruptured infected (Streptococcus agalactiae) AAA underwent the same procedure, except the graft was straight. Computed tomography of this patient revealed no graft dilation or surrounding fluid accumulation at 48 months after surgery. We therefore suggest that in situ replacement of the abdominal aorta using equine pericardium with concomitant omental flap wrapping may be an option of treating ruptured infected AAAs.