Surgical Treatment for Aseptic Mediastinitis in the Late Phase after Aortic Root and Arch Replacement

Abstract

Objective: A few cases of an aseptic abscess after thoracic aortic surgery have been reported. However, it sometimes requires surgical treatment because the rapid growth of perigraft fluid collection results in exposure towards the body surface. We discuss the results of our treatment of these cases. Methods: This study was a retrospective analysis. Four of 341 cases who underwent thoracic aortic surgery between April 2013 and March 2020 were included. These cases presented with a bulge of the body surface 10.3 (range, 3-27) months after surgery. Results: Although the fluids looked purulent in all cases, no bacteria were detected. We diagnosed them as aseptic abscess, for which omental implantation was performed. No signs of recurrence have been found in any cases even after 5.4 (range, 1-8.5) years. Conclusions: Omental implantation was effective for controlling aseptic abscess for long-term periods.