| Aortic Valve Replacement with
MRSA-Infected Osteoradionecrosis of the Chest Wall |
(Department of Cardiovascular Surgery, Mito Saiseikai
General Hospital, Mito, Japan)
| Kenji Aoki |
Setsuo Kuraoka |
Syo Tatebe |
|
A 75-year-old woman required aortic
valve replacement for aortic stenosis. She had undergone radical
mastectomy and irradiation for left breast cancer 25 years previously,
and had chest wall infection secondary to osteoradionecrosis.
In spite of preoperative infection controls including surgical
debridement, the chest wall was not healed well and colonized
with MRSA. However, she was too ill with severe heart failure
to wait until the chest wound was negative for MRSA for a valve
operation. With the infection remaining, the aortic valve was
approached through a right parasternal incision, to exclude the
infected sternum from the surgical site, and successfully replaced
with a mechanical valve. An internal mammary retractor was useful
to avoid fractures of the infected sternum and provided excellent
exposure of the aortic root. No mediastinitis or prosthetic valve
infection was encountered postoperatively.
Jpn. J. Cardiovasc. Surg. 33: 274-277 (2004) |
|
