Katayama Yuji, Minato Naoki, Kawasaki Hiromitsu, Sakaguchi Masayuki
Department of Thoracic and Cardiovascular Surgery, Fukuoka Tokushukai Hospital, Fukuoka, Japan.
Gen Thorac Cardiovasc Surg. 2008 Dec;56(12):584-8. doi: 10.1007/s11748-008-0302-3. Epub 2008 Dec 16.
Infection of the sternum and anterior mediastinitis after open heart surgery are serious complications that are intractable with high case fatality rates. Frequently, infection spreads to an artificial foreign body in the mediastinum, causing difficulties with treatment. We report a case of infected pseudoaneurysm of the aorta at the anastomotic site of the artificial vascular graft. The infection spread from sternal osteomyelitis 9 years 5 months after aortic root replacement (Bentall procedure) for acute aortic dissection. We performed radical surgery that included en bloc resection of the infected sternum, pseudoaneurysm, and artificial vascular graft, with successful results. We report here the surgical strategy including the approach.
心脏直视手术后胸骨感染和前纵隔炎是严重并发症，难以治疗且病死率高。感染常蔓延至纵隔内的人工异物，导致治疗困难。我们报告一例人工血管移植物吻合部位的主动脉感染性假性动脉瘤病例。感染在急性主动脉夹层行主动脉根部置换术（Bentall手术）9年5个月后从胸骨骨髓炎蔓延而来。我们实施了根治性手术，包括整块切除感染的胸骨、假性动脉瘤和人工血管移植物，结果成功。我们在此报告包括手术入路在内的手术策略。
