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深部胸骨伤口感染手术治疗后发生的严重心脏破裂。

Major cardiac rupture following surgical treatment for deep sternal wound infection.

作者信息

Thorsteinsson David T, Valsson Felix, Geirsson Arnar, Gudbjartsson Tomas

机构信息

Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland.

出版信息

Interact Cardiovasc Thorac Surg. 2013 May;16(5):708-9. doi: 10.1093/icvts/ivt004. Epub 2013 Jan 27.

Abstract

We report a case of an 80-year old male patient who sustained a major rupture of the right ventricle after surgical revision of an infected sternotomy wound following coronary artery bypass surgery. The rupture of the right ventricle occurred despite an early wound debridement and the use of negative pressure wound therapy on the sternum that did not provide sufficient stability to the sternum after the sternal wires were removed. The rupture resulted in a major bleeding but by establishing emergent cardiopulmonary bypass, the patient was saved.

摘要

我们报告一例80岁男性患者,该患者在冠状动脉搭桥手术后因感染性胸骨切开伤口进行手术修复后发生右心室严重破裂。尽管早期进行了伤口清创,并对胸骨使用了负压伤口治疗,但在拆除胸骨钢丝后,胸骨仍未获得足够的稳定性,右心室仍发生了破裂。破裂导致大量出血,但通过建立紧急体外循环,患者得以挽救。

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本文引用的文献

1
Negative-pressure wound therapy following cardiac surgery: bleeding complications and 30-day mortality in 176 patients with deep sternal wound infection.
Interact Cardiovasc Thorac Surg. 2011 Feb;12(2):117-20. doi: 10.1510/icvts.2010.252668. Epub 2010 Nov 24.
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