Texas Heart Institute journal
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In this study, we reviewed a 15-year experience with the treatment of a severe sequela of cardiac surgery: post-sternotomy mediastinitis. We compared the outcomes of conventional treatment with those of negative-pressure wound therapy, focusing on mortality rate, sternal reinfection, and length of hospital stay. We reviewed data on 157 consecutive patients who were treated at our institution from 1995 through 2010 for post-sternotomy mediastinitis after cardiac surgery. ⋯ Significantly shorter hospital stays were also observed with negative pressure in comparison with conventional treatment (mean durations, 27.3 ± 9 vs 30.5 ± 3 d; P = 0.02), consequent to the accelerated process of wound healing with negative-pressure therapy. Lower mortality and reinfection rates and shorter hospital stays can result from using negative pressure rather than conventional treatment. Therefore, negative-pressure wound therapy is advisable as first-choice therapy for deep sternal wound infection after cardiac surgery.
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Case Reports
Pulmonary valve leaflet extension with bovine pericardium: for treatment of pulmonary insufficiency.
Using a homograft in a pulmonic area is sometimes inadvisable due to the lack of optimal graft materials. We report a case of pulmonary valve insufficiency that we treated by leaflet extension using the commercially available E-Leafcon template and bovine pericardium. We suggest that this method can be an acceptable alternative for treating pulmonary valve insufficiency because the pulmonary valve area is similar to that of the aortic valve (for which application the template was designed). Further, the durability of bovine pericardium is comparable to that of a homograft or a xenograft.