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Expanding perigraft seroma after ascending aorta replacement
Shinji Kanemitsu1, Shunsuke Sakamoto2, Satoshi Teranishi2
1Department of Cardiovascular Surgery, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo, Aichi, 446-8602, Japan. skanemitsu70@gmail.com.
Journal of Cardiothoracic Surgery
|October 4, 2022
Summary
Perigraft seroma, a rare complication after thoracic aortic repair, can be effectively managed. Applying fibrin glue to the graft may prevent recurrence of this sterile fluid collection.
Area of Science:
- Cardiovascular Surgery
- Thoracic Aortic Aneurysm Repair
- Prosthetic Graft Complications
Background:
- Perigraft seroma is a rare, sterile fluid collection around grafts used in thoracic aortic repair.
- The exact mechanism of perigraft seroma formation after polyester graft use remains unclear.
- This complication is associated with surgical repair of the thoracic aorta.
Observation:
- A case report details a 77-year-old male treated for a large perigraft seroma one year post-ascending aorta replacement.
- The patient underwent repeat sternotomy for drainage of cloudy yellow fluid.
- The prosthetic graft was then covered with fibrin glue and a new graft.
Findings:
- Bacterial and laboratory analysis confirmed perigraft seroma.
- No recurrence was observed one year after the intervention.
- The fluid accumulation area around the graft significantly reduced post-surgery.
Implications:
- Chronic expanding mediastinal seroma is a recognized, albeit rare, complication of Dacron grafts in thoracic aortic surgery.
- Fibrin glue application to the graft surface shows promise in preventing perigraft seroma recurrence.
- Awareness of this complication is crucial for physicians managing thoracic aortic surgery patients.
