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

• DOI: 10.1007/s00380-006-0921-5
• Publication Date: 2006-12-01T10:23:16Z
• Authors: Takayoshi Kato; Hisato Takagi; Yukihiro Matsuno; Matsuhisa Imaizumi; Takuya Umemoto
• Keywords: Mediastinitis; Debridement (dental); Cardiothoracic surgery

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.