open access

Vol 21, No 3 (2014)
Case Reports
Published online: 2014-06-09
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Computer tomography guided transthoracic periaortic abscess needle biopsy in late mediastinitis after heart surgery

Tomasz Urbanowicz, Piotr Buczkowski, Wiktor Budniak, Izabela Katyńska, Maciej Walczak, Jadwiga Tomczyk, Marek Jemielity
DOI: 10.5603/CJ.2014.0045
·
Cardiol J 2014;21(3):325-328.

open access

Vol 21, No 3 (2014)
Case Reports
Published online: 2014-06-09

Abstract

Mediastinitis is a well-known complication of open heart surgery. Abscess as late complication, presenting years after heart surgery, is adegnotical. Transthoracic needle biopsies of lung parenchyma guided by computer tomography are widely accepted. The puncture of periaortic masses is not routinely performed. We report the case of an encapsulated mediastinal abscess localized next to ascending vascular graft. The febrile 47-year-old white male patient with history of Bentall operation was admitted to Cardiac Surgery Department. He was transferred for urgent chest tomography after International Normalization Ratio was reversed by prothrombin complex concentrate. Tomography revealed 7 × 5 × 4 cm mass between the sternum and ascending aorta, that was punctured by the needle. After biopsy specimen was sent for microbiology, the patient was transferred for surgery. There was no vascular graft invasion by the mass. The surgery was limited to abscess removal with postoperative drainage of periaortic area. The 6-week antibiotic therapy was applied. Patient recovered uneventfully.

Abstract

Mediastinitis is a well-known complication of open heart surgery. Abscess as late complication, presenting years after heart surgery, is adegnotical. Transthoracic needle biopsies of lung parenchyma guided by computer tomography are widely accepted. The puncture of periaortic masses is not routinely performed. We report the case of an encapsulated mediastinal abscess localized next to ascending vascular graft. The febrile 47-year-old white male patient with history of Bentall operation was admitted to Cardiac Surgery Department. He was transferred for urgent chest tomography after International Normalization Ratio was reversed by prothrombin complex concentrate. Tomography revealed 7 × 5 × 4 cm mass between the sternum and ascending aorta, that was punctured by the needle. After biopsy specimen was sent for microbiology, the patient was transferred for surgery. There was no vascular graft invasion by the mass. The surgery was limited to abscess removal with postoperative drainage of periaortic area. The 6-week antibiotic therapy was applied. Patient recovered uneventfully.

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Keywords

late mediastinitis, heart surgery, Bentall surgery, periaortic abscess, computer tomography guided biopsy, transthoracic needle biopsy, prothrombin complex concentrate

About this article
Title

Computer tomography guided transthoracic periaortic abscess needle biopsy in late mediastinitis after heart surgery

Journal

Cardiology Journal

Issue

Vol 21, No 3 (2014)

Pages

325-328

Published online

2014-06-09

DOI

10.5603/CJ.2014.0045

Bibliographic record

Cardiol J 2014;21(3):325-328.

Keywords

late mediastinitis
heart surgery
Bentall surgery
periaortic abscess
computer tomography guided biopsy
transthoracic needle biopsy
prothrombin complex concentrate

Authors

Tomasz Urbanowicz
Piotr Buczkowski
Wiktor Budniak
Izabela Katyńska
Maciej Walczak
Jadwiga Tomczyk
Marek Jemielity

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