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Mishin A.V.

Modern Medicine Center “Mediterra”

Kuatbekov K.N.

Modern Medicine Center “Mediterra”

Egizekov A.L.

Modern Medicine Center “Mediterra”

Tuganbaev A.E.

Modern Medicine Center “Mediterra”

VAC-assisted system in the treatment of early aortic prosthesis infection after Bentall-DeBono procedure complicated by mediastinitis

Authors:

Mishin A.V., Kuatbekov K.N., Egizekov A.L., Tuganbaev A.E.

More about the authors

Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2022;15(5): 530‑534

DOI: 10.17116/kardio202215051530

Views: 1226

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To cite this article:

Mishin AV, Kuatbekov KN, Egizekov AL, Tuganbaev AE. VAC-assisted system in the treatment of early aortic prosthesis infection after Bentall-DeBono procedure complicated by mediastinitis. Russian Journal of Cardiology and Cardiovascular Surgery. 2022;15(5):530‑534. (In Russ.)
https://doi.org/10.17116/kardio202215051530

 
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The choice of the most effective treatment method is essential for infectious lesions of mediastinum. We present successful use of combination of vacuum (VAC) and flow-flushing (FFS) systems in a 50-year-old patient with early aortic prosthesis infection after Benthall-DeBono procedure complicated by mediastinitis. The authors used topical negative pressure AND-aspirator device on the open sternum (115-125 mm Hg) combined with flow-flushing management with antiseptic solutions and antibacterial mixture of epicenter of inflammatory process (ascending aortic prosthesis). Ultrasound and computed tomography were performed to determine topography of lesions and severity of tissue destruction. The wound was cleansed after 17 days. The patient was discharged after normalization of acute phase clinical and laboratory parameters (8 days after sternum closure). Application of the most effective treatment method for infectious complications (negative pressure VAC systems combined with FFS) reduced bacterial insemination, stimulated tissue regeneration and prevented secondary infection in early aortic prosthesis infection after Benthall-DeBono procedure complicated by mediastinitis.

Keywords:

vacuum system
mediastinitis
Bentall-DeBono procedure
case report
cardiac surgery

Authors:

Mishin A.V.

Modern Medicine Center “Mediterra”

Kuatbekov K.N.

Modern Medicine Center “Mediterra”

Egizekov A.L.

Modern Medicine Center “Mediterra”

Tuganbaev A.E.

Modern Medicine Center “Mediterra”

Received:

28.08.2022

Accepted:

29.09.2022

List of references:

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  2. Grigoryan GR, Ivanov AA, Arakelyan VS. Infection of aortic explants: causes and methods of treatment. Bulletin of Experimental and Clinical Surgery. 2011;4(3):600-604. (In Russ.).
  3. Kirmani BH, Jones SG, Malaisrie SC, Chung DA, Williams RJ. Limited versus full sternotomy for aortic valve replacement. Cochrane Database Syst Rev. 2017;4(10):CD0117936. https://doi.org/10.1002/14651858.cd011793
  4. Suzuki K, Ishigami N, Akuzawa S. [Treatment of Mediastinitis after Open Heart Surgery Using Negative Pressure Wound Therapy with Irrigation]. Kyobu Geka. 2018 Oct;71(11):916-918. PMID: 30310001. (In Japanese).
  5. Onan IS, Yildiz O, Tüzün B, Timur B, Haydin S. Vacuum-Assisted Closure for Mediastinitis in Pediatric Cardiac Surgery: A Single-Center Experience. Artif Organs. 2019;43(2):119-124.  https://doi.org/10.1111/aor.13321
  6. Furgal AA, Reva IV, Reva GV, Sorokin VA, Garmash RA, Garmash AI, Kupatadze DD, Odintsova IA, Verin VK. Vacuum drainage in the treatment of postoperative mediastinitis in cardiac surgery. Modern Problems of Science and Education. 2018;6:111-111. (In Russ.). https://doi.org/10.17513/spno.28381
  7. Davydov YuA, Larichev AB, Abramov AK. Wound healing under vacuum drainage. Khirurgiya. 1992;7(8):21-26. (In Russ.).
  8. Morykwas MJ, Argenta LC, Shelto-Brown EI, McGuirt W. Vacuum-assisted closure: A new method for wound control and treatment. Animal studies and basic foundation. Ann Plast Surg. 1997;38:553-562.  https://doi.org/10.1097/00000637-199706000-00001
  9. Obdeijn MC, de Lange MY, Lichtendahl DHE, de Boer WJ. Vacuum assisted closure in the treatment of poststernotomy mediastinitis. Ann Thorac Surg. 1999;68:2538-2560. https://doi.org/10.1016/s0003-4975(99)01159-5
  10. Kokoev MB. Ascending aorta redo surgery after previous interventions on ascending aorta and aortic valve (surgical technique and results). Thoracic and Cardiovascular Surgery. 2015;4:11-21. (In Russ.).
  11. Umminger J, Krueger H, Beckmann E, Kaufeld T, Fleissner F, Haverich A, et al. Management of early graft infections in the ascending aorta and aortic arch: A comparison between graft replacement and graft preservation techniques. Eur J Cardiothorac Surg. 2016;50:660-667.  https://doi.org/10.1093/ejcts/ezw150

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