The Annals of Thoracic Surgery, Vol 46, 182-186, Copyright © 1988 by The Society of Thoracic Surgeons
Successful repair of postoperative ascending aortic mycotic false aneurysms using circulatory arrest
RM Bojar, DD Payne, AB Sheffield, H Rastegar, JJ Stetz and RJ Cleveland
Department of Cardiothoracic Surgery, New England Medical Center, 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.