An effective vacuum-assisted closure treatment for mediastinitis with aortic arch replacement

Yoshikatsu Saiki, Shunsuke Kawamoto, Sadahiro Sai, Koichi Tabayashi

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

Abstract

Little experience exists with the vacuum-assisted closure (VAC) therapy in the high-risk group of patients with perigraft abscess containing a large amount of prosthetic vascular grafts. We report our experience in the VAC therapy for patients with mediastinitis after aortic arch replacement. Between February 2003 and December 2006, five patients with a mean age of 72.2 years developed postoperative mediastinitis after aortic arch replacement, and were treated with the VAC system. In all the patients the mediastinal fluid and tissue examinations turned out to be negative for microbiological cultures, and successful closure of the midline incision was achieved with concomitant omental transfer after a mean duration of 22.6 days of VAC treatment. Four of the five patients survived to discharge and have been free from recurrent sign of mediastinal or graft infection at long-term follow-up. Our study indicates that the VAC treatment may reduce early mortality of life-threatening deep sternal wound infection complicated by a prior aortic arch replacement and become a preferred therapeutic option for the patients to whom another replacement is too risky.

Original languageEnglish
Pages (from-to)712-714
Number of pages3
JournalInteractive cardiovascular and thoracic surgery
Volume7
Issue number4
DOIs
Publication statusPublished - 2008 Aug

Keywords

  • Aortic arch
  • Mediastinal infection
  • Postoperative care

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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