A Case of Long Term Survival for Left Ventricular Assist Device Related Mediastinitis with Negative Pressure Wound Therapy
10.4326/jjcvs.41.76
- VernacularTitle:補助人工心臓装着後の縦隔炎に対して negative pressure wound therapy を施行して感染を制御し長期生存が得られている1症例
- Author:
Yasuhiro Hoshino
;
Takashi Nishimura
;
Mitsuhiro Kawata
;
Masahiko Andou
;
Osamu Kinoshita
;
Noboru Motomura
;
Arata Murakami
;
Syunei Kyo
;
Minoru Ono
- Publication Type:Journal Article
- Keywords:
LVAD;
NPWT;
mediastinitis
- From:Japanese Journal of Cardiovascular Surgery
2012;41(2):76-79
- CountryJapan
- Language:Japanese
-
Abstract:
A 44-year-old man who received left ventricular assist device (LVAD) implantation for end-stage heart failure due to dilated cardiomyopathy suffered from mediastinitis. Computed tomography confirmed mediastinitis. His mediastinum was reopened and irrigated. Negative pressure wound therapy (NPWT) was applied to the wound without closing the chest. This system enabled the patient to receive early physical rehabilitation. One year after LVAD implantation, under NPWT, the patient could walk in the general ward, and was waiting for cardiac transplantation. We used some useful materials for NPWT including a coatable non-alcoholic film, flexible sealing sheet, soft exudate absorber, in order to control wound clean, keep air-tight, prevent damage to the skin and to reduce mediastinal instability. LVAD implantation is usually performed as a bridge to transplantation or recovery. One of the most critical complications is intractable mediastinitis. We described a successful infection control of LVAD related mediastinitis with the NPWT.