Department of Cardiovascular Surgery, Klinik Im Park, Zürich, Switzerland.
Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland.
J Card Surg. 2021 Jul;36(7):2558-2561. doi: 10.1111/jocs.15544. Epub 2021 Apr 21.
The 7-year long-term survival after Aspergillus fumigatus mediastinitis after heart transplantation, an uncommonly described condition, is herein reported. A 66-year-old male developed an infection with A. fumigatus covering the entire thoracic cavity with a fungal turf after orthotopic heart transplantation. Repeated surgical removal of infectious and necrotic tissue together with innovative topical treatment using voriconazole and chlorhexidine combined with systemic antifungal treatment, helped in controlling the infection. Definitive wound closure was achieved by standard sternal refixation and latissimus dorsi muscle flap plasty. Survival after A. fumigatus mediastinitis after heart transplantation was achieved with sequential debridement in combination with topical application of antifungal agents.
本文报告了一例罕见的曲霉菌性纵隔炎 7 年长期生存病例。一名 66 岁男性在接受原位心脏移植后，感染了烟曲霉菌，整个胸腔都覆盖着真菌性地毯。反复手术切除感染性和坏死性组织，以及使用伏立康唑和洗必泰联合全身抗真菌治疗的创新局部治疗，有助于控制感染。通过标准胸骨重新固定和背阔肌皮瓣成形术实现了确定性伤口闭合。曲霉菌性纵隔炎经心脏移植后，通过连续清创术联合局部应用抗真菌药物治疗获得了生存。
