Massive Bleeding After Median Sternotomy: Case Report of an Infrequent Complication of Infective Endocarditis

Authors: Laura Varela Barca, Jose Lopez Menendez, Ana Redondo Palacios, Jorge Rodriguez Roda Stuart

bstract We report an unusual complication of acute infective endocarditis, found in a 70 year-old man with a previous history of two cardiac surgery procedures. The first one was a full root replacement (BentallDe Bono procedure), associated with three bypasses (one mammary and two vein grafts). The second procedure was a mitral valve replacement through a right thoracotomy ought to native mitral valve endocarditis. In the current admission, echocardiography showed a periaortic abscess (Figure 1) and severe prosthetic mitral valve insufficiency. CT scan showed a big collection in the anterior mediastinal space adjacent to the composite graft (Figure 2), which was suspected to be purulent material. A third surgical intervention was programmed despite the extreme surgical risk. During the median sternotomy, a massive bleeding occurred. It was originated in the mediastinal collection, which truly was a collection of contained bleeding, originated in the 10 yearsold anastomosis of the saphenous vein to the composite graft, which was completely detached due to endocarditic involvement of the aortic graft. The institution of cardiopulmonary bypass before sternal opening enabled the surgical team to maintain a stable hemodynamic situation and to continue the procedure satisfactorily. You can submit your Manuscripts at: 

Comments: 3 Pages.

Download: PDF

Submission history

[v1] 2017-08-29 07:17:11

Unique-IP document downloads: 1 times is a pre-print repository rather than a journal. Articles hosted may not yet have been verified by peer-review and should be treated as preliminary. In particular, anything that appears to include financial or legal advice or proposed medical treatments should be treated with due caution. will not be responsible for any consequences of actions that result from any form of use of any documents on this website.

Add your own feedback and questions here:
You are equally welcome to be positive or negative about any paper but please be polite. If you are being critical you must mention at least one specific error, otherwise your comment will be deleted as unhelpful.

comments powered by Disqus