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Successful Surgical Therapy of a Chronically Infected Thoracic Fistula After Repeated Cardiovascular High-Risk
Nikolaus Thierfelder1, Eva Riedlinger2, Sinan Mert1
1Division of Hand, Plastic and Aesthetic Surgery University Hospital of Munich, LMU Munich Germany.
None:
Chronic thoracic fistulas after transapical TAVI are rare but serious complications. A 67-year-old male with prior aortic dissection and two transapical valve implantations developed a chronically infected fistula due to retained apical closure material. Multidisciplinary surgery with complete removal of infected tissue, staged debridement, vacuum-assisted closure (VAC) therapy, and targeted antibiotics achieved infection control and successful wound reconstruction using local flaps. The patient recovered uneventfully. Complete foreign material removal and interdisciplinary management are crucial for durable healing in high-risk posttransapical TAVI patients.
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