Heart and Vessels

, Volume 21, Issue 6, pp 392–394 | Cite as

High-pressure irrigation and gentian-violet application for mediastinitis following replacement of ascending aorta and aortic valve

  • Takayoshi Kato
  • Hisato Takagi
  • Yukihiro Matsuno
  • Matsuhisa Imaizumi
  • Takuya Umemoto
CASE REPORT

Abstract

Mediastinitis following ascending aortic replacement is intractable and potentially fatal, and the feature is characterized as having both high mortality and morbidity when its causation pathology is methicillin-resistant Staphylococcus aureus (MRSA). Possible treatments for the condition, which include debridement, irrigation, and healthy tissue transposition, often result in failure. We report a case of MRSA mediastinitis after replacement of the ascending aorta and the aortic valve successfully treated by continuous saline lavage and drainage, debridement, high-pressure irrigation, and gentian-violet application, and delayed omental-flap transposition. The application of gentian violet and high-pressure irrigation may provide an additional option to the standard therapy for intractable mediastinitis after ascending aortic replacement.

Key words

Mediastinitis Prosthetic graft Ascending aorta Methicillin-resistant Staphylococcus aureus Gentian violet 

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References

  1. 1.
    Mathes, DW, Yaremchuk, MJ, Isselbacher, EM, Madsen, JC 2000Successful in situ treatment of an infected ascending aortic graftAnn Thorac Surg7014101412PubMedCrossRefGoogle Scholar
  2. 2.
    Fridkin, SK, Hageman, JC, Morrison, M, Sanza, LT, Como-Sabetti, K, Jernigan, JA, Harriman, K, Harrison, LH, Lynfield, R, Farley, MM 2005Methicillin-resistant Staphylococcus aureus disease in three communitiesN Engl J Med35214361444PubMedCrossRefGoogle Scholar
  3. 3.
    Sheagren, JN 1984Staphylococcus aureus. The persistent pathogenN Engl J Med31014371442PubMedCrossRefGoogle Scholar
  4. 4.
    Hirn, MYJ, Salmela, PM, Vuento, RE 2001High-pressure saline washing of allografts reduces bacterial contaminationActa Orthop Scand728385PubMedCrossRefGoogle Scholar
  5. 5.
    Rogness, H 1985High-pressure wound irrigationJ Enterostom Ther122728Google Scholar
  6. 6.
    Saji, M 1992Effect of gentiana violet against methicillin-resistant Staphylococcus aureus (MRSA)Kansenshogaku Zasshi66914922PubMedGoogle Scholar
  7. 7.
    Okano, M, Noguchi, A, Tabata, K, Matsumoto, Y 2000Topical gentian violet for cutaneous infection and nasal carriage with MRSAInt J Dermatol39942944PubMedCrossRefGoogle Scholar
  8. 8.
    Drinkwater, P 1990Gentian violet – is it safe?Aust NZ J Obstet Gynaecol306566Google Scholar

Copyright information

© Springer-Verlag Tokyo 2006

Authors and Affiliations

  • Takayoshi Kato
    • 1
  • Hisato Takagi
    • 1
  • Yukihiro Matsuno
    • 1
  • Matsuhisa Imaizumi
    • 1
  • Takuya Umemoto
    • 1
  1. 1.Department of Cardiovascular SurgeryShizuoka Medical CenterShizuokaJapan

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