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Mediastinal perigraft seroma after thoracic aortic surgery

Ryo Suzuki1, Masafumi Akita1, Suguru Miyazaki1

  • 1Department of Cardiovascular Surgery, Shinmatsudo Central General Hospital, Matsudo, Japan.

Interdisciplinary Cardiovascular and Thoracic Surgery
|September 4, 2023
PubMed
Abstract

Insights

Mediastinal perigraft seroma (PGS) after thoracic aortic surgery is linked to high ejection fraction, warfarin use, and aortic dissection. These factors are crucial for understanding and managing PGS development post-surgery.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Medical Imaging

Background:

  • Mediastinal perigraft seroma (PGS) is a rare complication following thoracic aortic surgery.
  • Clinical reviews detailing abundant mediastinal PGS cases are infrequent.
  • This study investigates factors contributing to PGS and provides a clinical review.

Purpose of the Study:

  • To identify key factors associated with mediastinal perigraft seroma (PGS) after thoracic aortic surgery.
  • To offer a clinical review of mediastinal PGS, addressing the rarity of extensive case reports.
  • To analyze patient data to determine predictors of PGS formation.

Main Methods:

  • Eighty-two patients undergoing ascending or aortic arch replacement (2016-2022) were studied.
  • Postoperative CT scans identified fluid collections (≥3.0 cm, ≤25 HU).
  • Multivariate logistic regression analyzed significant variables, including literature-based factors.

Main Results:

  • The incidence of PGS was 14.6% (12/82 patients).
  • Average seroma radiodensity was 16.6 ± 6.3 HU, with onset at 8.5 months post-surgery.
  • Significant predictors for PGS included ejection fraction (OR: 1.25), aortic dissection (OR: 6.61), and warfarin use (OR: 6.67).

Conclusions:

  • Elevated ejection fraction, warfarin use, and aortic dissection are significant contributors to mediastinal PGS.
  • These findings aid in understanding the etiology of PGS after thoracic aortic procedures.
  • Serial postoperative imaging and fluid analysis are recommended for guiding treatment strategies.
Keywords:
Mediastinal perigraft seromaPerigraft fluid collectionSeroma after vascular surgeryThoracic aortic surgery

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