title: Successful treatment of an infected new vascular graft.
abstract: A 71-year old male who underwent total aortic arch replacement using a newly developed uncoated vascular prosthesis (Triplex®) developed postoperative mediastinitis due to a methicillin-resistant Staphylococcus infection. The Triplex® vascular prosthesis has a unique three-layer structure with a non-porous elastomer middle layer material and has several advantages over more traditional prosthesis, namely, good manipulability, good patency, dilatation resistance, and low inflammatory tissue reaction. This is the first reported case of a postoperative prosthesis infection that was successfully treated by omentum wrapping and closed irrigation with triphenylmethane dye. Bacterial cultures of blood samples were negative throughout the course of treatment, and 8 months after the initial operation. Computer tomographs revealed no evidence of infection or anastomotic pseudoaneurysms. In conclusion, the combination of omentum wrapping and the closed irrigation procedure using triphenylmethane dye can be considered to be an effective treatment for Triplex® graft infection.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan. susumuishikawa@hotmail.co.jp
authors.forename: Susumu
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Katayama
authors.forename: Hideki
authors.initials: H
authors.lastname: Mishima
authors.forename: Kenji
authors.initials: K
authors.lastname: Ohnishi
mesh_terms: D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D005840:Gentian Violet / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D009852:Omentum / Q000601:surgery; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D013524:Surgical Flaps; D007507:Therapeutic Irrigation / Q000379:methods; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D005840:Gentian Violet