Ventricular pulling sign on computed tomography in mediastinitis—a predictor for right ventricular rupture at surgery

Hidenobu Takaki, Kenichi Hashizume, Kanako Hayashi, Hiroaki Kaneyama

Research output: Contribution to journalArticle

Abstract

Mediastinitis is an unusual but potentially life-threatening complication of cardiac surgery. Open drainage is one of the standard therapies, but there could sometimes be potential complications. We had a patient who underwent open drainage surgery for postoperative mediastinitis, and right ventricular rupture occurred subsequently to extubation in an operation room. Retrospectively reviewed, computed tomography showed strong adhesions between the right ventricle and the posterior margin of sternum, pulling his right ventricle to the right side of his sternum. We should have noticed the risk of leaving the sternum open and performed adhesiolysis of the right ventricle and the posterior margin of sternum to prevent the devastating complication. This case illustrates the importance of recognizing the rare computed tomography sign of ventricular pulling—a predictor for right ventricular rupture after open drainage for mediastinitis.

Original languageEnglish
JournalIndian Journal of Thoracic and Cardiovascular Surgery
DOIs
Publication statusAccepted/In press - 2020
Externally publishedYes

Keywords

  • Complications
  • Mediastinal infection
  • Reoperation
  • Right ventricular rupture

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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