Successful treatment of MRSA mediastinitis after aortic arch replacement

An aortic arch graft replacement was successfully performed for a true aneurysm on the distal aortic arch. However, Methicillin-resistant Staphylococcus aureus (MRSA) mediastinitis occurred after surgery. Following reoperation for debridement and irrigation of the mediastinal space, antibiotics were administered and continuous irrigation of mediastinal space with saline containing appropriate antibiotics and intermittently short duration irrigation with a large quantity of saline containing popidone-iodine were carried out with good results. This paper presents the successful treatment of mediastinitis after replacement of the aortic arch without removing the graft, followed by a brief review of the literature regarding infection of prostetic grafts for the thoracic aorta.