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术后胸骨浅表伤口感染导致的延迟性主动脉破裂。

Delayed aortic rupture resulting from postoperative superficial sternal wound infection.

作者信息

Kim Su Wan, Lee Seogjae, Chang Jee Won

机构信息

Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.

出版信息

J Thorac Dis. 2016 Jul;8(7):E523-6. doi: 10.21037/jtd.2016.05.09.

Abstract

While deep sternal wound infection (DSWI) after cardiac surgery is a significant contributor to patient morbidity and mortality, superficial sternal wound infection (SSWI) mostly has a benign course. We report a mortality case of aortic rupture resulting from SSWI after cardiac surgery. A 50-year-old male underwent an aortic valve replacement (AVR). Three months after the valve operation, he presented with severe dyspnea, which had never before been observed, and chest computed tomography revealed an ascending aortic rupture with large hematoma compressing the main pulmonary artery. We performed an emergent operation for aortic rupture that possibly originated from the SSWI. Postoperatively, the patient died of hypovolemic shock due to recurrent aortic rupture despite efforts to resuscitate him.

摘要

虽然心脏手术后的深部胸骨伤口感染(DSWI)是导致患者发病和死亡的重要因素,但浅表胸骨伤口感染(SSWI)大多病程良性。我们报告一例心脏手术后因SSWI导致主动脉破裂的死亡病例。一名50岁男性接受了主动脉瓣置换术(AVR)。瓣膜手术后三个月,他出现了前所未有的严重呼吸困难,胸部计算机断层扫描显示升主动脉破裂并伴有巨大血肿压迫主肺动脉。我们对可能源于SSWI的主动脉破裂进行了急诊手术。术后,尽管努力对患者进行复苏,但患者仍因复发性主动脉破裂死于低血容量性休克。

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