Mediastinitis following Graft Replacement of the Ascending and Total Arch Aorta in Two Cases
10.4326/jjcvs.35.147
- VernacularTitle:上行弓部全置換術後の縦隔洞炎の２症例
- Author:
Atsushi Tamura
;
Yoshiharu Takahara
;
Kenji Mogi
;
Masayoshi Katsumata
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2006;35(3):147-150
- CountryJapan
- Language:Japanese
-
Abstract:
Mediastinitis following graft replacement of the ascending and total arch aorta is a fatal complication of cardiac surgery. When graft infection is suspected, one choice of treatment is to remove the infected prosthesis and replace it with a new one. However such a procedure seems to be very risky. We report 2 successfully treated cases of mediastinitis following graft replacement of the ascending and total arch aorta. In one case, we treated with primary sternal closure after debridement and omental flap implant. In another case, the wound was left open and irrigation with iodine solution was undertaken for 6 days. The sternum was closed with pectoralis major muscle flap implantation. When graft infection is not suspected, primary sternal closure with implantation of tissue flaps is recommended. When graft infection is strongly suspected, we prefer secondary sternal closure after open irrigation.
