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[A case of two staged operation of pericardial abscess after left-ventricular aneurysmectomy]
Insights
A patient developed a rare cardio-cutaneous fistula after multiple cardiac surgeries. Successful radical repair highlights the risks of artificial materials in treating complex cardiac complications.
Area of Science:
- Cardiovascular Surgery
- Surgical Complications
- Medical Device Materials
Background:
- A 54-year-old male with a history of myocardial infarction underwent left ventricular aneurysmectomy and coronary artery bypass grafting.
- Six years post-surgery, he developed a pericardial abscess requiring surgical drainage.
- Two years after the drainage procedure, a pulsatile cardio-cutaneous fistula emerged.
Observation:
- The patient presented with a challenging cardio-cutaneous fistula, a rare complication following cardiac surgery.
- The fistula required complex surgical intervention under cardiopulmonary bypass for definitive treatment.
Findings:
- Radical surgical repair of the cardio-cutaneous fistula was successfully performed.
- The patient experienced an uneventful recovery and has been doing well post-operation.
Implications:
- This case underscores the potential complications associated with artificial materials like Teflon felt in cardiac surgery.
- Careful consideration and limited use of synthetic materials are advised for managing complex post-surgical cardiac fistulas.
Abstract:
A 54-year-old man who had undergone the left ventricular aneurysmectomy and double saphenous vein bypass grafting for the old myocardial infarction suffered from the pericardial abscess 6 years after the first operation. He was operated upon the persistent drainage of the lesion and returned to his daily life. Two years after the 2nd operation, he recognized pulsatile bleeding from the fistula and was admitted to our hospital. He underwent the radical operation for the cardio cutaneous fistula under the cardiopulmonary bypass. The post operative course was uneventful and he has continued to do well. We discussed the treatment for this kind of complication and stressed the limited usage of Teflon felt and other artificial materials.