title: Successful therapy for a patient with an infected ascending aortic graft and sternal osteomyelitis without graft removal.
abstract: OBJECTIVE
  Following open-heart surgery, sternal osteomyelitis or infection of the graft may be a serious complication with high mortality rates. The recommended treatment of an infected graft is its explantation. Because of the poor performance status of the patient, this may not always be an option. We report a successful treatment concept without removal of the infected graft.
  
  
  METHODS
  The infected ascending aortic graft and the remaining sternum of a critically ill 60-year-old man were covered with a bilateral pectoralis muscle flap.
  
  
  RESULTS
  Postoperatively, the laboratory test values normalized and the patient was discharged 1 month after the intervention. One year after surgery, the patient was in good condition and the examination showed no signs of infection.
  
  
  CONCLUSIONS
  The thus demonstrated treatment concept with insertion of well-vascularized tissues in combination with a specific antibiotic regime in our hands proved to be an additional option for the successful management of life-threatening infections of a sternal osteomyelitis in combination of an infected aortic graft.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital of Basel, Basel, Switzerland. schmiddo@uhbs.ch
authors.forename: Dominik W
authors.initials: DW
authors.lastname: Schmid
authors.forename: Christina
authors.initials: C
authors.lastname: Orasch-Jörg
authors.forename: Reto
authors.initials: R
authors.lastname: Wettstein
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Kalbermatten
authors.forename: Atanas
authors.initials: A
authors.lastname: Todorov
authors.forename: Gerhard
authors.initials: G
authors.lastname: Pierer