Postoperative mediastinitis following hemiarch replacement: successful treatment using omental flap transposition.
Although various strategies have been advocated for mediastinitis following cardiac operations, surgical results for this complication remain a significant concern. The condition would be more complicated with replacement of the ascending aorta using a prosthetic graft. We present the case of a 50-year-old female patient with acute aortic dissection who underwent hemiarch replacement using a prosthetic graft and concomitant coronary artery bypass grafting, and developed periprosthetic purulent collection 2 months later. Successful treatment involved debridement ofìnfected tissues and omental flap transposition. Postoperative chest computed tomography revealed no sign of perigraft infection. Omental flap transposition can be effective for treating mediastinitis following prosthetic graft replacement of the ascending aorta. The patient has remained in good health for 1 year, with no signs of recurrent graft infection or pseudoaneurysm formation.
Tsutsumi
Koji
K
Division of Cardiovascular Surgery, Cardiovascular Center, Sagamihara Kyodo Hospital, Kanagawa, Japan.
Ookura
Mikihiko
M
D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008480:Mediastinitis / Q000601:surgery*; D008875:Middle Aged; D009852:Omentum; D011183:Postoperative Complications; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000601:surgery