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Late outcome after surgical and topical treatment for Aspergillus mediastinitis after heart transplantation
Author(s) -
Vogt Paul R.,
Aser Raed,
Schmidlin Daniel,
Mohacsi Paul,
Berdat Pascal A.,
Went Phillip,
Flepp Markus,
Mestres Carlos A.
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15544
Subject(s) - medicine , mediastinitis , voriconazole , aspergillus fumigatus , heart transplantation , surgery , debridement (dental) , transplantation , caspofungin , aspergillosis , antifungal , dermatology , immunology
The 7‐year long‐term survival after Aspergillus fumigatus mediastinitis after heart transplantation, an uncommonly described condition, is herein reported. A 66‐year‐old male developed an infection with A. fumigatus covering the entire thoracic cavity with a fungal turf after orthotopic heart transplantation. Repeated surgical removal of infectious and necrotic tissue together with innovative topical treatment using voriconazole and chlorhexidine combined with systemic antifungal treatment, helped in controlling the infection. Definitive wound closure was achieved by standard sternal refixation and latissimus dorsi muscle flap plasty. Survival after A. fumigatus mediastinitis after heart transplantation was achieved with sequential debridement in combination with topical application of antifungal agents.