小儿心脏手术中的纵隔炎：一种罕见的并发症。单中心经验。
Mediastinitis in pediatric cardiac surgery: an unusual complication. A single-center experience.
作者信息
Manosalva Arciniegas Laura Isabel, Vargas Soler José Antonio, Guevara Rodríguez Lyneira Juliana, González Hakspiel Laura Constanza, Rubio Duarte Andrés Felipe, Mendoza Crespo Sara Elena
机构信息
Fundación Cardiovascular de Colombia, Floridablanca, Colombia. Fundación Cardiovascular de Colombia Floridablanca Colombia.
出版信息
Arch Peru Cardiol Cir Cardiovasc. 2025 Jun 27;6(2):63-68. doi: 10.47487/apcyccv.v6i2.471. eCollection 2025 Apr-May.
OBJECTIVES
Mediastinitis is an unusual postoperative complication in pediatric cardiovascular surgery, associated with high morbidity and mortality. Case reports are limited, especially in Latin America, where cardiac surgery has advanced significantly.
MATERIALS AND METHODS
A retrospective study of mediastinitis post-cardiac surgery cases at a high-complexity center in Colombia, between January 2015 and June 2023, was conducted. A detailed description of the clinical characteristics and therapeutic approaches was provided.
RESULTS
A population of 16 children with mediastinitis was characterized, predominantly male (68.7%); 62.5% were aged 1-3 months. The most common defects were transposition of the great arteries and univentricular heart. Gram-negative bacteria (37.5%) were the most common isolates, followed by gram-positive bacteria (25%). Vacuum-assisted closure (VAC) was required in 43.7% of cases.
CONCLUSION
Advances in congenital heart disease management have led to complications such as mediastinitis, prompting the development of therapeutic strategies that would benefit from better characterization in high-complexity centers to improve outcomes.
目的
纵隔炎是小儿心血管手术中一种罕见的术后并发症，发病率和死亡率都很高。病例报告有限，尤其是在心脏手术发展显著的拉丁美洲。
材料与方法
对2015年1月至2023年6月哥伦比亚一家高复杂性中心心脏手术后纵隔炎病例进行回顾性研究。提供了临床特征和治疗方法的详细描述。
结果
对16例纵隔炎患儿进行了特征分析，其中男性占主导（68.7%）；62.5%的患儿年龄在1至3个月之间。最常见的缺陷是大动脉转位和单心室心脏。革兰氏阴性菌（37.5%）是最常见的分离菌，其次是革兰氏阳性菌（25%）。43.7%的病例需要使用负压封闭引流（VAC）。
结论
先天性心脏病治疗的进展导致了纵隔炎等并发症，促使人们制定治疗策略，而在高复杂性中心进行更好的特征分析将有助于改善治疗效果。
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