Hagiwara K, Hamada O, Itabashi K, Hoshino S, Iwaya F, Igari T, Tanji M, Watanabe M, Motoki R
Kyobu Geka. 1989 Dec;42(13):1127-30.
The patient was 63-year-old man, who underwent patch closure of VSP 37 days after onset. LVAD was required for weaning from CPB. Mediastinitis occurred after LVAD was removed. The mediastinum was irrigated using diluted antibiotics through the retrosternal drain. He discharged on 79th day postoperatively. False aortic aneurysm and marked AR was pointed out by cineangiography and enhanced CT scan two years after operation. AVR was performed through right thoracotomy, because false aortic aneurysm invaded the sternum. The aneurysmal wall was repaired with patch. Postoperatively, peritoneal dialysis was performed for two days. Flail chest made difficult weaning from the respirator. He died 11 days postoperatively due to respiratory failure. There remains the possibility that mediastinitis resulted in false aortic aneurysm and AR. It was esseutial to remove the foreign materials placed on the aorta for eradication of infection.
该患者为一名63岁男性，发病37天后接受了室间隔穿孔修补术。脱机需要左心室辅助装置（LVAD）。移除LVAD后发生了纵隔炎。通过胸骨后引流管使用稀释抗生素冲洗纵隔。患者于术后第79天出院。术后两年的电影血管造影和增强CT扫描显示有假性主动脉瘤和明显的主动脉反流（AR）。由于假性主动脉瘤侵犯胸骨，通过右胸切开术进行了主动脉瓣置换术（AVR）。用补片修复动脉瘤壁。术后进行了两天的腹膜透析。连枷胸使脱机困难。患者术后11天因呼吸衰竭死亡。纵隔炎导致假性主动脉瘤和AR仍有可能。为根除感染，必须移除置于主动脉上的异物。
