Infectious Mediastinitis After Cardiac Operations: Computed Tomographic Findings

Misawa, Yoshio; Fuse, Katsuo; Hasegawa, Takemi

doi:10.1016/s0003-4975(97)01339-8

Cited by 55 publications

(37 citation statements)

References 5 publications

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“…mortality rate has dropped to figures lower than 10%, even in cases of cardiac transplantation 2,8 . In our study, the incidence of mediastinitis and its mortality confirmed the severity of that entity, which was observed by other authors 3,6,8 . Grossi et al 7 , in an analysis of 7,949 patients undergoing cardiac operations, observed that only 0.97% of patients developed mediastinitis.…”

Section: Discussionsupporting

confidence: 92%

“…Serial Mediastinitis after cardiac transplantation Arq Bras Cardiol volume 74, (nº 5), 2000 analysis of echocardiography and computed tomography provides substantial information concerning the appearance of pericardial or retrosternal collections because transplantation significantly modifies mediastinal anatomy 3 . It should be emphasized that more important than isolated analysis of a single examination is the daily clinical observation associated with clinical and laboratory findings.…”

Section: Discussionmentioning

confidence: 99%

“…In transplantation this complication is especially feared because of the resulting high mortality rate. The treatment of mediastinitis has improved in recent years because of expansion of the available resources for investigation, allowing a reduction in the time required for diagnosis and treatment [2][3][4] . This study aims to report the experience acquired in the treatment of patients developing mediastinitis after cardiac transplantation in the last 14 years.…”

Section: Original Articlementioning

confidence: 99%

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Mediastinitis after cardiac transplantation

Fiorelli

Bacal

et al. 2000

Arq. Bras. Cardiol.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Original Articlementioning

confidence: 99%

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Mediastinitis after cardiac transplantation

Fiorelli

Bacal

et al. 2000

Arq. Bras. Cardiol.

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“…Common CT findings in sternal osteomyelitis include bone destruction with demineralization and dehiscence [39]. Because aseptic hematoma or fluid collection in the mediastinum can be seen 2-3 weeks after sternotomy, it is not always easy to differentiate normal findings from those of infectious mediastinitis and abscess formation [40]. If mediastinal fluid collection with air persists for 2 weeks after operation, with redness and discharge from the sternotomy site, infectious mediastinitis should be suspected [41].…”

Section: Sternal Osteomyelitis and Mediastinitismentioning

confidence: 99%

Postoperative Complications after Surgical Aortic Valve Replacement

Koo

Lee

Anh

et al. 2017

Cardiovasc Imaging Asia

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Aortic valve replacement is one of the most common major cardiac surgeries worldwide. Despite improvements in surgical techniques, postoperative complications after aortic valve surgery remain a source of substantial morbidity and mortality. Although transthoracic echocardiography and transesophageal echocardiography have been used for routine surveillance of prosthetic heart valves, computed tomography (CT) has played an important role with echocardiography in the diagnosis, treatment, and follow-up of patients after valve replacement. CT has the advantage of evaluating the extent of disease, such as paravalvular dehiscence, abscess, and pseudoaneurysm, in aortic prosthetic valves. In this article, we review the various image findings of postoperative complications after aortic valve replacement detected on CT.

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“…Epicardial pacing wire cultures are not satisfactory for the diagnosis of mediastinitis [50] , while bacteriological samples from the sternal or retrosternal puncture are considered safe and powerful [51] . CT scans have been considered of great value to localize infected tissues [52] , however, there is also some doubt about the validity of a CT scan in performing an early diagnosis [53,54] . Furthermore, erroneous diagnoses due to Surgicel packing [55] , to Surgicel body foreign reaction [56] or to iodine accumulation following irrigation [57] have been reported.…”

Section: Diagnosismentioning

confidence: 99%

Mediastinitis in pediatric cardiac surgery: Prevention, diagnosis and treatment

Durandy¹

2010

WJC

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In spite of advances in the management of mediastinitis following sternotomy, mediastinitis is still associated with significant morbidity. The prognosis is much better in pediatric surgery compared to adult surgery, but the prolonged hospital stays with intravenous therapy and frequent required dressing changes that occur with several therapeutic approaches are poorly tolerated. Prevention includes nasal decontamination, skin preparation, antibioprophylaxis and air filtration in the operating theater. The expertise of the surgical team is an additional factor that is difficult to assess precisely. Diagnosis is often very simple, being made on the basis of a septic state with wound modification, while retrosternal puncture and CT scan are rarely useful. Treatment of mediastinitis following sternotomy is always a combination of surgical debridement and antibiotic therapy. Continued use of numerous surgical techniques demonstrates that there is no consensus and the best treatment has yet to be determined. However, we suggest that a primary sternal closure is the best surgical option for pediatric patients. We propose a simple technique with high-vacuum Redon's catheter drainage that allows early mobilization and short term antibiotherapy, which thus decreases physiological and psychological trauma for patients and families. We have demonstrated the efficiency of this technique, which is also cost-effective by decreasing intensive care and hospital stay durations, in a large group of patients.

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Infectious Mediastinitis After Cardiac Operations: Computed Tomographic Findings

Cited by 55 publications

References 5 publications

Mediastinitis after cardiac transplantation

Mediastinitis after cardiac transplantation

Postoperative Complications after Surgical Aortic Valve Replacement

Mediastinitis in pediatric cardiac surgery: Prevention, diagnosis and treatment

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