Case
Report |
An Aortic Root Pseudoaneurysm That Developed after Implantation of a Rectus Abdominis Muscle Flap to Treat an MRSA Mediastinitis: A Case Report |
| Takeshiro Fujii, MD, Yoshinori Watanabe, MD, Noritsugu Shiono, MD, Tsukasa Ozawa, MD, Satoshi Hamada, MD, Hiroshi Masuhara, MD, Chikao Teramoto, MD, Masanori Hara, MD, Tomonori Katayanagi, MD, Yuki Sasaki, MD, and Nobuya Koyama, MD |
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| 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 reperformed 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.
(Ann Thorac Cardiovasc Surg 2010; 16: 63-66) |
| Key words: aortic root reconstruction, mediastinitis, methicillin-resistant Staphylococcus aureus, continuous lavage, rectus abdominis muscle flap implantation |
Division of Cardiovascular Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
Received September 3, 2008; accepted for publication January 23, 2009.
Address reprint requests to Takeshiro Fujii, MD: Division of Cardiovascular Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Toho University, 6–11–1 Omorinishi, Ota-ku, Tokyo 143–8541, Japan. |
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