[Infection of ascending aortic graft: treatment with surgical cleaning, graft preservation and transposition of muscle flaps. Report of two cases].
Mediastinitis with graft infection is a serious complication of ascending aorta replacement. We report two cases of graft infection, treated with surgical cleaning, graft preservation and transposition of muscle flaps. A 62 years old male was admitted 34 days after an ascending aortic grafting due to a sternal dehiscence and mediastinitis. Antimicrobial treatment was started and a surgical cleaning performed, leaving an open sternotomy. Three days later, the thoracic cavity was closed with a rectus abdominis muscle flap. After 23 months of follow up, the patient is well and without evidence of infection. A 74 years old male was subjected to an aortic valve and ascending aorta replacement and a myocardial revascularization. In the postoperative period, the patient developed septic signs, and a purulent drainage. A CAT scan showed a liquid collection surrounding the aortic graft. On tW Sixteenth postoperative day, a surgical cleaning was performed and the thorax was closed with the pectoralis major muscle. After 10 months of follow up, the patient is in Good condition and without evidence of infection.
Zalaquett
R
R
Departamentos de Enfermedades Cardiovasculares, Cirugía Plástica y Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile. rzalaque@med.puc.cl
Vidal
P
P
Irarrázaval
M J
MJ
Arroyo
C
C
Pérez
C
C
Labarca
J
J
D000368:Aged; D001011:Aorta / Q000637:transplantation*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000601:surgery*; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000601:surgery*; D011552:Pseudomonas Infections / Q000382:microbiology; D013203:Staphylococcal Infections / Q000382:microbiology; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed