Thorac Cardiovasc Surg 2000; 48(4): 243-244
DOI: 10.1055/s-2000-6891
Case Report
ORIGINALARBEIT
© Georg Thieme Verlag Stuttgart · New York

Omental Flap for Mediastinitis after Median Sternotomy in Asplenia Syndrome and Gut Malrotation

R. Aeba, T. Katogi, K. Moro, S. Kawada
  • Division of Cardiovascular Surgery, Keio University, Tokyo, Japan
Further Information

Publication History

Publication Date:
31 December 2000 (online)

We describe a 12-year-old patient with asplenia syndrome and gut malrotation who, after an interim step before a modified Fontan operation, developed life-threatening mediastinitis. A flap of the omentum arising from the transverse colon, longitudinally located in the left of the abdomen, was created and transferred to the mediastinum after a division of the arterial arcade at its most caudal extent. Her postoperative course was uneventful, and 12 months later, the modified Fontan operation was successfully completed. Although visceral heterotaxy results in an omental deformation, it does not preclude the use of an omental flap.

References

  • 1 Waldman J D, Rosenthal A, Smith A L, Shurin S, Nadas A S. Sepsis and congenital asplenia.  J Pediatr.. 1977;  90 555-9
  • 2 Biggar W D, Ramirez R A, Rose V. Congenital asplenia: immunologic assessment and a clinical review of eight surviving patients.  Pediatrics.. 1981;  67 548-51
  • 3 Stiegel R M, Beasley M E, Sink J D, Hester T R, Guyton R A, Perrella A M, Williams W H. Management of postoperative mediastinitis in infants and children by muscle flap rotation.  Ann Thorac Surg.. 1988;  46 45-6
  • 4 Backer C L, Pensler J M, Tobin G R, Mavroudis C. Vascularized muscle flaps for life-threatening mediastinal wounds in children.  Ann Thorac Surg.. 1994;  57 797-802
  • 5 Phoon C K, Neill C A. Asplenia Syndrome: Insight into embryology through an analysis of cardiac and extracardiac anomalies.  Am J Cardiol.. 1994;  73 581-7

Received for Publication: August 23, 1999

Dr. Ryo Aeba

Division of Cardiovascular Surgery, Keio University

35 Shinanomachi Shinjuku Tokyo 160-8582 Japan

Email: E-mail: aeba@mc.med.keio.ac.jp