title: High-pressure irrigation and gentian-violet application for mediastinitis following replacement of ascending aorta and aortic valve.
abstract: Mediastinitis following ascending aortic replacement is intractable and potentially fatal, and the feature is characterized as having both high mortality and morbidity when its causation pathology is methicillin-resistant Staphylococcus aureus (MRSA). Possible treatments for the condition, which include debridement, irrigation, and healthy tissue transposition, often result in failure. We report a case of MRSA mediastinitis after replacement of the ascending aorta and the aortic valve successfully treated by continuous saline lavage and drainage, debridement, high-pressure irrigation, and gentian-violet application, and delayed omental-flap transposition. The application of gentian violet and high-pressure irrigation may provide an additional option to the standard therapy for intractable mediastinitis after ascending aortic replacement.
authors.affiliation: Department of Cardiovascular Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka 411-8611, Japan. takkato.nine-lives@s5.dion.ne.jp
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Kato
authors.forename: Hisato
authors.initials: H
authors.lastname: Takagi
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Matsuno
authors.forename: Matsuhisa
authors.initials: M
authors.lastname: Imaizumi
authors.forename: Takuya
authors.initials: T
authors.lastname: Umemoto
mesh_terms: D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001011:Aorta / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery; D003131:Combined Modality Therapy; D003646:Debridement; D005840:Gentian Violet / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000382:microbiology / Q000628:therapy*; D016106:Methicillin Resistance; D011183:Postoperative Complications; D019736:Prostheses and Implants / Q000382:microbiology; D013203:Staphylococcal Infections / Q000628:therapy*; D013524:Surgical Flaps; D007507:Therapeutic Irrigation; D014057:Tomography, X-Ray Computed
chemical_list: D000890:Anti-Infective Agents; D005840:Gentian Violet