Candida mediastinitis after double closure technique for repairing ventricular septal perforation

A 69-year-old man was referred to our hospital due to acute myocardial infarction. Systolic heart murmur was first noted on the 23rd day after the onset, but no cardiac shunt flow was detected by echocardiography at that time. Six days later, cardiac function deteriorated rapidly, followed by oligur...

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Bibliographic Details
Published inKyobu geka. The Japanese journal of thoracic surgery Vol. 62; no. 3; p. 215
Main Authors Ueyama, K, Koyama, M, Otaki, K, Terashima, T, Nishimiya, T
Format Journal Article
LanguageJapanese
Published Japan 01.03.2009
Subjects
Aged
Candidiasis - surgery
Cardiac Surgical Procedures - methods
Humans
Male
Mediastinitis - surgery
Myocardial Infarction - complications
Omentum - surgery
Postoperative Complications
Treatment Outcome
Ventricular Septal Rupture - etiology
Ventricular Septal Rupture - surgery
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Summary:A 69-year-old man was referred to our hospital due to acute myocardial infarction. Systolic heart murmur was first noted on the 23rd day after the onset, but no cardiac shunt flow was detected by echocardiography at that time. Six days later, cardiac function deteriorated rapidly, followed by oliguria and shock. Re-do echocardiography showed ventricular septal perforation. Emergency operation was performed, and septal perforation was seen on the anterior portion of the septum. In addition to infarct-exclusion-technique (Komeda-David method) with the equine pericardial patch, direct closure of the septal defect was performed (double closure technique). Fibrin glue was applied between the ventricular septum and the patch. After surgery, he suffered from Candida mediastinitis and received omentum plombage. Furthermore tracheotomy was performed for pneumonia. He recovered gradually, and was discharged about 3 months after surgery. Echocardiography showed no residual shunt.
ISSN:0021-5252