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Robert M. Bojar
Douglas D. Payne
Anne B. Sheffield
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Joseph J. Stetz
Richard J. Cleveland
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Ann Thorac Surg 1988;46:182-186
© 1988 The Society of Thoracic Surgeons

Articles

Successful Repair of Postoperative Ascending Aortic Mycotic False Aneurysms Using Circulatory Arrest

Robert M. Bojar, M.D.*, Douglas D. Payne, M.D., Anne B. Sheffield, C.C.P., Hassan Rastegar, M.D., Joseph J. Stetz, M.D., Richard J. Cleveland, M.D.

From the Department of Cardiothoracic Surgery, New England Medical Center and the Tufts University School of Medicine, Boston, MA

Accepted for publication February 3, 1988.

* Address reprint requests to Dr. Bojar, New England Medical Center Hospitals, 750 Washington St, Boston, MA 02111.

Mediastinal wound infections following open-heart operations are successfully managed in most patients by aggressive debridement and placement of substernal drainage catheters or application of omental or muscle flaps. Nonetheless, the involvement of foreign bodies, such as felt pledgets adjacent to cardiac structures, can result in infections that persist despite flap coverage and can present as mycotic false aneurysms of the ascending aorta. We present the cases of 3 patients who underwent successful repair of such aneurysms late after surgical treatment of mediastinal wound infections. We describe our technique of repair using groin cannulation for bypass, moderate hypothermia, and circulatory arrest to improve exposure and minimize bleeding.




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