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. 2022 Jul 9;35(2):ivac177.
doi: 10.1093/icvts/ivac177.

Autologous free tissue transfer in paediatric patient with a univentricular heart

Felix J Jacobi  1 , Simon F Jacobi  2 , Fabian A Kari  3 , Steffen U Eisenhardt  1
Affiliations

Autologous free tissue transfer in paediatric patient with a univentricular heart

Felix J Jacobi et al. Interact Cardiovasc Thorac Surg. .

Abstract

We report on the case of a 30-month-old boy who developed severe deep cervical necrosis after bypass surgery for total cavopulmonary connection, followed by low-cardiac output and extracorporeal life support. As several bedside debridements failed to result in sufficient wound healing, a 2-stage necrectomy followed by autologous reconstruction with a free anterolateral thigh-flap was required. Due to impaired circulation, postoperative flap monitoring was extremely difficult. To ensure flap perfusion, mean arterial pressure had to be raised by catecholamines over 7 days.

Keywords: Anterolateral thigh-flap; Central venous line; Impaired peripheral circulation; Total cavopulmonary connection; Univentricular heart.

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Figures

Figure 1:
Figure 1:
(A) Cervical necrosis affecting the sternocleidomastoideus muscle (*). (B) Raised anterolateral thigh-flap; vascular pedicle (→) and preoperatively marked Doppler signal site (x). (C) Intra- and postoperative paleness and marbled skin depicting impaired flap perfusion.
Figure 2:
Figure 2:
(A and B) Six months postoperative.
See this image and copyright information in PMC

References

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