01 September 2003
Mediastinal sterno-cutaneous fistula after early prosthetic valve endocarditis
Vedat Nisanoglu, Nevzat Erdil, Akin Kuzucu, Bektas BattalogluCase Rep Clin Pract Rev 2003; 4(2):97-99 :: ID: 429042
Abstract
Background: Deep sternal wound infection after heart surgery is rare but devastating complication associated with significant morbidity, mortality and cost. Management of a sternal osteomyelitis is still difficult and is a subject of controversy. In this paper, we report a case with sternal osteomyelitis communicated to anterior mediastinum that was successfully treated with partial sternal resection and pectoralis major muscular flap reconstruction. Case Report: A 28-year-old woman underwent mitral valve replacement due to early prosthetic valve endocarditis. One month later purulent drainage developed at sternotomy incision and wound culture revealed Methicillin resistant staphylococcus aureus This organism was also responsible for prosthetic valve endocarditis. Sinographic fistulogram showed a mediastinal cutaneous fistula which is communicated to anterior mediastinum that the tract was lay down along the epicardial pacemaker leads which had been left in mediastinum. The patient was successfully treated with partial sternal resection and pectoralis major muscular flap reconstruction. Conclusions: In patients at risk for native or prosthetic valve endocarditis, to eradicate and remove the potential focus for bacteremia is mandatory. Mediastinal cutaneous fistula could potentially cause bacteremia that had possible potential risk for prosthetic valve endocarditis. The abandoned epicardial pacemaker leads may facilitate development of mediastinal fistula and sternal osteomyelitis. Partial sternal resection and muscle flap reconstruction can be safe and an effective for the patient who had suffered from and had tendency for infective endocarditis.
Keywords: Heart Valve Prosthesis, Endocarditis, Fistula, Diagnostic Imaging, Surgery
50
In Press
19 Mar 2024 : Case report
Bilateral Simultaneous Basal Ganglia Hemorrhage: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.943174
19 Mar 2024 : Case report
Medial Hoffa Fracture: A Case Report and Literature Review of Approach and ManagementAm J Case Rep In Press; DOI: 10.12659/AJCR.943136
21 Mar 2024 : Case report
Pediatric Neurogenic Pulmonary Edema After Brain Tumor Removal Complicated with Severe Myocardial Injury: A...Am J Case Rep In Press; DOI: 10.12659/AJCR.943645
21 Mar 2024 : Case report
Chlamydia psittaci Pneumonia: Diagnosis, Treatment, and Challenges in the Context of COVID-19Am J Case Rep In Press; DOI: 10.12659/AJCR.942921
Most Viewed Current Articles
07 Mar 2024 : Case report
Neurocysticercosis Presenting as Migraine in the United StatesDOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
10 Jan 2022 : Case report
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
19 Jul 2022 : Case report
Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19DOI :10.12659/AJCR.936128
Am J Case Rep 2022; 23:e936128
23 Feb 2022 : Case report
Penile Necrosis Associated with Local Intravenous Injection of CocaineDOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250