J Pediatr Intensive Care 2018; 07(03): 163-165
DOI: 10.1055/s-0038-1624562
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Successful Salvage of an Extracardiac Fontan in the Setting of Purulent Mediastinitis using Antibiotic-Impregnated Beads

Matthew T. Coghill
1  Congenital Heart Center, Levine Children's Hospital, Charlotte, North Carolina
,
Gonzalo A. Wallis
1  Congenital Heart Center, Levine Children's Hospital, Charlotte, North Carolina
,
Paul M. Kirshbom
1  Congenital Heart Center, Levine Children's Hospital, Charlotte, North Carolina
,
Thomas S. Maxey
1  Congenital Heart Center, Levine Children's Hospital, Charlotte, North Carolina
› Author Affiliations
Further Information

Publication History

23 October 2017

19 December 2017

Publication Date:
06 February 2018 (eFirst)

Abstract

Post-cardiotomy mediastinitis is an especially serious complication after the implantation of prosthetic vascular grafts. Standard of care is irrigation, debridement, and removal of all prosthetic material present in the surgical field. The use of antibiotic impregnated beads at the site of infection has been reported in the salvage of vascular grafts in the adult population. We present the case of a 3-year-old child with hypoplastic left heart syndrome who developed mediastinitis following the Fontan operation. In a nontraditional approach, the Fontan conduit, which was surrounded by gross purulence, was successfully salvaged with the adjunctive use of vancomycin-impregnated beads.