Mediastinitis in pediatric cardiac surgery: An unusual complication. A single - center experience

Laura Isabel Manosalva Arciniegas; José Antonio Vargas Soler; Lyneira Juliana Guevara Rodríguez; Laura Constanza González Hakspiel; Andrés Felipe Rubio Duarte; Sara Elena Mendoza Crespo

doi:10.47487/apcyccv.v6i2.471

Autores/as

Laura Isabel Manosalva Arciniegas Fundación Cardiovascular de Colombia, Floridablanca, Colombia. https://orcid.org/0009-0007-3431-4752
José Antonio Vargas Soler Fundación Cardiovascular de Colombia, Floridablanca, Colombia. https://orcid.org/0000-0001-6613-0666
Lyneira Juliana Guevara Rodríguez Fundación Cardiovascular de Colombia, Floridablanca, Colombia. https://orcid.org/0009-0009-3030-6768
Laura Constanza González Hakspiel Fundación Cardiovascular de Colombia, Floridablanca, Colombia. https://orcid.org/0000-0002-5456-3189
Andrés Felipe Rubio Duarte Fundación Cardiovascular de Colombia, Floridablanca, Colombia. https://orcid.org/0000-0001-9091-5367
Sara Elena Mendoza Crespo Fundación Cardiovascular de Colombia, Floridablanca, Colombia. https://orcid.org/0000-0002-6460-0588

DOI:

https://doi.org/10.47487/apcyccv.v6i2.471

Palabras clave:

Mediastinitis, Pediatrics, Cardiovascular Surgery, Negative-Pressure Wound Therapy

Resumen

Objectives. Mediastinitis is an unusual postoperative complication in pediatric cardiovascular surgery, associated with high morbidity and mortality. Case reports are limited, especially in Latin America, where cardiac surgery has advanced significantly. Materials and methods. A retrospective study of mediastinitis post-cardiac surgery cases at a high-complexity center in Colombia, between January 2015 and June 2023, was conducted. A detailed description of the clinical characteristics and therapeutic approaches was provided. Results. A population of 16 children with mediastinitis was characterized, predominantly male (68.7%); 62.5% were aged 1–3 months. The most common defects were transposition of the great arteries and univentricular heart. Gram-negative bacteria (37.5%) were the most common isolates, followed by gram-positive bacteria (25%). Vacuum-assisted closure (VAC) was required in 43.7% of cases. Conclusion. Advances in congenital heart disease management have led to complications such as mediastinitis, prompting the development of therapeutic strategies that would benefit from better characterization in high-complexity centers to improve outcomes.

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