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Successful Management of Mediastinitis After Bentall Procedure

Year 2014, Issue: 3, 243 - 245, 01.09.2014

Abstract

Purulent mediastinitis with an ascending aortic composite valve conduit is a serious dilemma for surgeons who must choose between changing or saving the prosthetic graft. Here, we treated a mediastinitis case without explanting and replacing the ascending aortic prosthetic valve conduit and instead saved the conduit with aggressive debridement, irrigation and omental transposition. The patient was discharged at postoperative 42nd day, control examination revealed no active infection or mechanical complications at 3 month

References

  • Hargrove WC, Edmunds LHJ. Management of infected thoracic aortic prosthetic grafts. Ann Thorac Surg 1984;37:72–7.
  • Bitkover CY, Gårdlund B. Mediastinitis after cardiovascular operations: a case-control study of risk factors. Ann Thorac Surg 1998;65:36–40.
  • Villavicencio MA, Orszulak TA, Sundt III TM et al. Thoracic aorta false aneurysm: What surgical strategy should be recommended?. Ann Thorac Surg 2006;82:81-9
  • Coselli JS, Koksoy C, LeMaire SA. Management of thoracic aortic graft infections. Ann Thorac Surg 1999;67:1990 –3.
  • Nakajima N, Masuda M, Ichinose M, Ando M. A new method for the treatment of graft infection in the thoracic aorta: in situ preservation. Ann Thorac Surg 1999;67:1994–6.
  • Krabatsch T, Hetzer R. Infected ascending aortic prosthesis: Successful treatment by thoracic transposition of the greater omentum. Eur J Cardiothorac Surg 1995;9:223–5.
  • Samoukovic G, Bernier PL, Lachapelle K. Successful treatment of infected ascending aortic prosthesis by omental wrapping without graft removal. Ann Surg Thorac Surg 2008;86:287-9
  • Mo A, Lin H. Successful therapy for a patient with aortic graft infection without graft removal. Ann Vasc Surg 2011;25:698.e1-e4
  • LeMaire SA, DiBardino DJ, Köksoy C, Coselli JS. Proximal aortic reoperations with composite valve grafts. Ann Thorac Surg 2002;74:S1777-80

BENTALL PROSEDÜRÜ SONRASI GELİŞEN MEDİASTİNİTTE BAŞARILI BİR TEDAVİ SÜRECİ

Year 2014, Issue: 3, 243 - 245, 01.09.2014

Abstract

Bentall prosedürü geçirmiş ve mediastende prostetik konduit grefti bulunan hastalarda mediastinit önemli bir komplikasyondur. Tedavide grefin değişimi söz konusu olabilmekle birlikte, konservatif yöntemler de tercih edilebilir. Biz de Bentall Prosedürü sonrası gelişen mediastinitte, agresif debridman, irrigasyon ve omentum transpozisyonu ile tedavi ettiğimiz bir vakayı sunuyoruz. Hasta postoperative 42. günde taburcu edildi ve 3. ay kontrolünde enfeksiyon veya mekanik komplikasyon saptanmadı

References

  • Hargrove WC, Edmunds LHJ. Management of infected thoracic aortic prosthetic grafts. Ann Thorac Surg 1984;37:72–7.
  • Bitkover CY, Gårdlund B. Mediastinitis after cardiovascular operations: a case-control study of risk factors. Ann Thorac Surg 1998;65:36–40.
  • Villavicencio MA, Orszulak TA, Sundt III TM et al. Thoracic aorta false aneurysm: What surgical strategy should be recommended?. Ann Thorac Surg 2006;82:81-9
  • Coselli JS, Koksoy C, LeMaire SA. Management of thoracic aortic graft infections. Ann Thorac Surg 1999;67:1990 –3.
  • Nakajima N, Masuda M, Ichinose M, Ando M. A new method for the treatment of graft infection in the thoracic aorta: in situ preservation. Ann Thorac Surg 1999;67:1994–6.
  • Krabatsch T, Hetzer R. Infected ascending aortic prosthesis: Successful treatment by thoracic transposition of the greater omentum. Eur J Cardiothorac Surg 1995;9:223–5.
  • Samoukovic G, Bernier PL, Lachapelle K. Successful treatment of infected ascending aortic prosthesis by omental wrapping without graft removal. Ann Surg Thorac Surg 2008;86:287-9
  • Mo A, Lin H. Successful therapy for a patient with aortic graft infection without graft removal. Ann Vasc Surg 2011;25:698.e1-e4
  • LeMaire SA, DiBardino DJ, Köksoy C, Coselli JS. Proximal aortic reoperations with composite valve grafts. Ann Thorac Surg 2002;74:S1777-80
There are 9 citations in total.

Details

Primary Language Turkish
Journal Section Case Report
Authors

Cem Arıtürk

Mehmet Hakan Akay

Şahin Şenay

Ahmet Ümit Güllü

Hasan Karabulut

Hüseyin Cem Alhan

Publication Date September 1, 2014
Published in Issue Year 2014Issue: 3

Cite

EndNote Arıtürk C, Akay MH, Şenay Ş, Güllü AÜ, Karabulut H, Alhan HC (September 1, 2014) BENTALL PROSEDÜRÜ SONRASI GELİŞEN MEDİASTİNİTTE BAŞARILI BİR TEDAVİ SÜRECİ. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 3 243–245.