Post-Mediastinitis Ventricle Rupture:. Closing the Chest Without Closing the Heart?

Abstract

Right ventricular rupture following mediastinitis is an unusual but potentially life-threatening complication of cardiac surgery, related to the "open" debridement technique. There are few reports of complex surgical management including repair of the tear and wound closure with omentoplasty or muscle flap with ECC. We report the case of a patient with a right ventricular rupture complicating mediastinitis, which was successfully treated by direct closure of the chest wall without repairing the ventricle tearing and without ECC. We believe that it can be a quick and effective solution at first attempt, and may be a successful and definitive treatment.

Acellular cadaveric dermis (Alloderm) for ventricular coverage after a gunshot wound

“…Repair of a ventricular wall with rectus fascia, Teflon during cardiopulmonary bypass and primary or secondary wound closure using pectoral myoplasty, omentoplasty, or muscle flap are demanding techniques in an emergency situation. 5 Even if technically complex surgery may be done, the prognosis remains poor. 16,17 The management of penetrating cardiac injuries in the setting of a patient with multiple gunshot wounds along with multiple organ injuries poses a challenge for the trauma surgeon.…”