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
37
In Press
05 Mar 2024 : Case report
Simultaneous Transcatheter Closure of a Ventricular Septal Defect and Pulmonary Valvuloplasty: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.942032
06 Mar 2024 : Case report
Successful Healing of Periapical Pathology with Partial Pulpotomy in a Mature Permanent Molar: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.942937
12 Mar 2024 : Case report
Successful Treatment of Lithium-Induced Nephrogenic Diabetes Insipidus with Celecoxib: A Promising Therapeu...Am J Case Rep In Press; DOI: 10.12659/AJCR.943244
13 Mar 2024 : Case report
Recurrent Marginal Zone Lymphoma with Bone Marrow Involvement Detected by ¹⁸F-FDG PET/CT and Biopsy: A Diag...Am J Case Rep In Press; DOI: 10.12659/AJCR.943275
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