title: An aortic root pseudoaneurysm that developed after implantation of a rectus abdominis muscle flap to treat an MRSA mediastinitis: a case report.
abstract: The occurrence of mediastinitis following synthetic vascular replacement surgery is still associated with an unfavorable prognosis in the treatment of thoracic aortic diseases. This time we report a Bentall procedure that we re-performed to treat an aortic root pseudoaneurysm, which developed after a postoperative mediastinitis. This followed the first Bentall procedure, which was treated by debridement of the focus of infection, continuous lavage, and a two-step rectus abdominis muscle flap implantation. Implantation of a rectus abdominis muscle flap is effective in controlling infection in the treatment of mediastinitis after heart surgery. However, after synthetic vascular replacement surgeries have been performed to treat aortic diseases, especially after aortic root reconstruction surgery, which puts stress on the anastomotic site, consideration should be given regarding the development of hemorrhages and pseudoaneurysms as a result of infection-induced tissue fragilization.
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Toho University, 6-11-1 Omorinishi, Ota-ku, Tokyo, Japan.
authors.forename: Takeshiro
authors.initials: T
authors.lastname: Fujii
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Noritsugu
authors.initials: N
authors.lastname: Shiono
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Ozawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hamada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Masuhara
authors.forename: Chikao
authors.initials: C
authors.lastname: Teramoto
authors.forename: Masanori
authors.initials: M
authors.lastname: Hara
authors.forename: Tomonori
authors.initials: T
authors.lastname: Katayanagi
authors.forename: Yuki
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Nobuya
authors.initials: N
authors.lastname: Koyama
mesh_terms: D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D001344:Autopsy; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D003646:Debridement; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000382:microbiology / Q000601:surgery*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D017568:Rectus Abdominis / Q000637:transplantation*; D012086:Reoperation; D013524:Surgical Flaps / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult