Nakajima Tomohiro, Iba Yutaka, Shibata Tsuyoshi, Kawaharada Nobuyoshi
Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.
Egypt Heart J. 2023 Oct 6;75(1):80. doi: 10.1186/s43044-023-00411-z.
After a median sternotomy, mediastinitis may develop, necessitating reopening of the chest. Rarely, reoperation due to hematoma after cardiovascular surgery is experienced. In the present case, we experienced a patient who initially had mediastinitis, but later developed a chronic hematoma and underwent multiple surgeries.
The patient was a 40-year-old man who underwent aortic valve replacement for a bicuspid aortic valve and a graft for a dilated ascending aorta. Postoperatively, he developed hematoma in the anterior mediastinum on multiple occasions with repeated episodes of infection that required multiple median sternotomies.
We reported our experience with a rare case of multiple median sternotomies. In the early stage, mediastinitis due to infection was observed, and in the late stage, mediastinal dilatation due to hemorrhage was observed.
正中开胸术后可能发生纵隔炎，需要再次开胸。心血管手术后因血肿而再次手术的情况较为罕见。在本病例中，我们遇到一名患者，最初患有纵隔炎，但后来出现慢性血肿并接受了多次手术。
该患者为一名40岁男性，因二叶式主动脉瓣行主动脉瓣置换术，并因升主动脉扩张行血管移植术。术后，他多次在前纵隔出现血肿，并伴有反复感染发作，需要多次正中开胸。
我们报告了这例罕见的多次正中开胸病例的经验。早期观察到因感染导致的纵隔炎，晚期观察到因出血导致的纵隔扩张。
