A Case of Long Term Survival for Left Ventricular Assist Device Related Mediastinitis with Negative Pressure Wound Therapy

(Graduate School of Medicine, Department of Cardiac Surgery, and Graduate School of Medicine Therapeutic Strategy for Heart Failure*, The University of Tokyo, Tokyo, Japan)

Yasuhiro Hoshino Takashi Nishimura* Mitsuhiro Kawata
Masahiko Andou Osamu Kinoshita Noboru Motomura
Arata Murakami Syunei Kyo* Minoru Ono
A 44-year-old man who received left ventricular assist device(LVAD)implantation for end-stage heart failure due to dilated cardiomyopathy suffered from mediastinitis. Computed tomography confirmed mediastinitis. His mediastinum was reopened and irrigated. Negative pressure wound therapy(NPWT)was applied to the wound without closing the chest. This system enabled the patient to receive early physical rehabilitation. One year after LVAD implantation, under NPWT, the patient could walk in the general ward, and was waiting for cardiac transplantation. We used some useful materials for NPWT including a coatable non-alcoholic film, flexible sealing sheet, soft exudate absorber, in order to control wound clean, keep air-tight, prevent damage to the skin and to reduce mediastinal instability. LVAD implantation is usually performed as a bridge to transplantation or recovery. One of the most critical complications is intractable mediastinitis. We described a successful infection control of LVAD related mediastinitis with the NPWT.
  Jpn. J. Cardiovasc. Surg. 41:76-79(2012)