Mycotic pseudoaneurysm complicating flap closure of an infected median sternotomy

Area of Science:

• Cardiovascular Surgery
• Infectious Disease
• Vascular Surgery

Background:

• Postoperative mediastinitis is a serious complication following cardiac surgery.
• Pseudoaneurysms (false aneurysms) are recognized, albeit infrequent, sequelae of cardiac surgery.
• Mediastinitis can compromise surgical repairs and lead to vascular complications.

Observation:

• This case report describes a rare pseudoaneurysm.
• The pseudoaneurysm involved a flap used for infected mediastinum closure.
• This represents the first documented instance of such an occurrence.

Findings:

• Pseudoaneurysm formation in the context of infected mediastinum flap closure is a life-threatening complication.
• Early recognition of specific clinical presentations is crucial for diagnosis.
• Diagnostic imaging plays a key role in identifying these vascular abnormalities.

Implications:

• This case underscores the importance of considering pseudoaneurysm in patients with persistent infection or unusual symptoms post-cardiac surgery with mediastinal involvement.
• Awareness of this complication can guide diagnostic workups and treatment strategies.
• Further research may be warranted to understand the incidence and optimal management of pseudoaneurysms in this specific surgical context.