A 24-year-old woman with patent ductus arteriosus underwent division of the ductus. On the fifth postoperative day (POD 5), MRSA was detected in pus from the wound. On POD 8, an emergency operation was performed for left tension hemothorax due to a ruptured aorta with MRSA infection. The bleeding site in the descending aorta was covered with a viable omental flap under deep hypothermic circulatory arrest. Although MRSA was detected in the pleural effusion and the aortic wall, the patient recovered from pyothorax, and pneumonia caused by Pseudomonas aeruginosas and acute renal failure. On POD 37, a pseudoaneurysm of the descending aorta was found and graft replacement was performed on POD 56 due to enlargement of the aneurysm. However, MRSA was not detected in the left pleural effusion. The postoperative course was uneventful. Omental transfer should be considered for the treatment of severe aortic wall infection, even in the presense of MRSA infection.

Methods: We examined medical records from a single central database for 65 patients receiving surgical treatment for ASD. Statistical comparisons were made between patients who experienced postoperative POH and those who did not, by examining patient and operative characteristics, such as age, sex, comorbidities, functional status, preoperative neurological function, vertebral fractures, three-column osteotomy, total operative time, estimated blood loss, length of stay, and radiographic parameters. The determinants of POH were assessed using multiple logistic regression. Results: We showed that postoperative POH was a complication of ASD surgery, with a 9% incidence rate. Patients with POH were statistically considerably more likely to require supported walkers due to partial paralysis and to have comorbidities including diabetes and neurodegenerative disease (ND). Furthermore, ND was an independent risk factor for postoperative POH (odds ratio, 4.073; 95% confidence interval, 1.094–8.362; p =0.020). Moreover, perioperative evaluation of the inferior vena cava showed that patients with postoperative POH had preoperative congestive heart failure and had hypovolemia lower postoperative diameter of the inferior vena cava than patients without POH. Conclusions Postoperative POH is a potential complication of ASD surgery. The most pertinent risk factor is having an ND. According to our study, patients who have surgery for ASD may experience alterations in their hemodynamics.