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Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
A near-fatal case of pyoderma gangrenosum following coronary artery bypass surgery
Ahmed Mohamed Abdel Shafi1, Abed Elfattah Atieh1, Reza Alamouti2
1Department of Cardiothoracic Surgery, Barts Heart Centre, St. Bartholomew's Hospital, London, UK.
Abstract:
A 58-year-old man on azathioprine with a history of ulcerative colitis underwent urgent coronary artery bypass grafting following a myocardial infarction, via a median sternotomy and open harvesting of the long saphenous vein. On postoperative day 5, he developed severe and progressive sternal and leg wound ulceration and necrosis, unresponsive to intravenous antibiotics and requiring surgical debridement. He developed septic shock requiring intensive therapy unit admission. Microbiology was negative and histology supported a diagnosis of pyoderma gangrenosum. Unresponsive to azathioprine and steroid therapy, he underwent a successful skin graft to the leg wound and pectoral reconstruction of the sternal wound.
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