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Ann Thorac Surg 2001;71:1028-1030
© 2001 The Society of Thoracic Surgeons

Case report

Innominate artery rupture after transcervical drainage for descending necrotizing mediastinitis

Hideo Ichimura, MDa, Shigemi Ishikawa, MDa, Yuji Hiramatsu, MDa, Yuzuru Sakakibara, MDa, Masataka Onizuka, MDa

a Department of Surgery, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan

Accepted for publication September 17, 2000.

Address reprint requests to Dr Ishikawa, Department of Surgery, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan
e-mail: ishikawa{at}md.tsukuba.ac.jp

We present a case of innominate artery rupture after descending necrotizing mediastinitis (DNM) on day 36 of cervicomediastinal drainage. The patient recovered after aortosubclavian arterial bypass grafting followed by resection of the eroded artery. Because mechanical pressure caused by drains in addition to the inflammatory process can cause major vessel erosion, prolonged transcervical tube drainage for treating descending necrotizing mediastinitis should be avoided even if the drains applied are soft and thin.






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