Right ventricular rupture due to recurrent mediastinal infection with a closed chest.
Right ventricular (RV) rupture in cases of mediastinitis following cardiac surgery is a rare and dangerous complication. Bleeding from the right ventricle occurs mainly after sternal reopening, due to either iatrogenic manipulation (wire removal, lesions due to wiring maneuvers) or mechanical shearing forces, producing direct injury. We present a case of RV wall perforation due to infection in a recurrent postoperative mediastinitis with a closed chest. The current literature on treatment of postoperative mediastinitis is also reviewed.
Niclauss
Lars
L
Department of Cardiac Surgery, Hôpital cantonal de Sion, Av. Grand-Champsec 80, Sion, Switzerland. lars.niclauss@chuv.ch
Delay
Dominique
D
Stumpe
Frank
F
D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001026:Coronary Artery Bypass / Q000009:adverse effects; D004322:Drainage; D006341:Heart Rupture / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D006352:Heart Ventricles / Q000382:microbiology; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D054843:Negative-Pressure Wound Therapy; D012008:Recurrence; D012086:Reoperation; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D013212:Staphylococcus epidermidis / Q000302:isolation & purification*; D056346:Sternotomy / Q000009:adverse effects*; D013529:Surgical Wound Dehiscence / Q000382:microbiology; D013530:Surgical Wound Infection / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D013536:Suture Techniques; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents