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. 2025 Jun 27;6(2):63-68.
doi: 10.47487/apcyccv.v6i2.471. eCollection 2025 Apr-May.

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

Laura Isabel Manosalva Arciniegas  1 , José Antonio Vargas Soler  1 , Lyneira Juliana Guevara Rodríguez  1 , Laura Constanza González Hakspiel  1 , Andrés Felipe Rubio Duarte  1 , Sara Elena Mendoza Crespo  1
Affiliations

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

Laura Isabel Manosalva Arciniegas et al. Arch Peru Cardiol Cir Cardiovasc. .

Abstract
in English, Spanish

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.

Objetivo: La mediastinitis es una complicación posoperatoria inusual en cirugía cardiovascular pediátrica, asociada con alta morbilidad y mortalidad. Los reportes de casos son limitados, especialmente en Latinoamérica, donde la cirugía cardíaca ha avanzado significativamente.

Materiales y métodos: Estudio retrospectivo de casos de mediastinitis pediátrica poscirugía cardíaca en un centro de alta complejidad en Colombia, entre enero de 2015 y junio de 2023. Se realizó una descripción detallada de las características clínicas y las estrategias terapéuticas.

Resultados: Se caracterizó una población de 16 niños con mediastinitis, predominantemente varones (68,7%). El 62,5% tenía edades de 1 a 3 meses. Los defectos más comunes fueron la transposición de las grandes arterias y el corazón univentricular. Las bacterias gramnegativas (37,5%) fueron los aislamientos más comunes, seguidas de las grampositivas (25%). Se requirió cierre asistido por vacío (VAC) en el 43,7% de los casos.

Conclusiones: Los avances en el manejo de las cardiopatías congénitas han provocado complicaciones como la mediastinitis, lo que ha impulsado el desarrollo de estrategias terapéuticas que se beneficiarían de una mejor caracterización en centros de alta complejidad para mejorar los resultados.

Keywords: Cardiovascular Surgery; Mediastinitis; Negative-Pressure Wound Therapy; Pediatrics.

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Conflict of interest statement

Conflicts of interest: Nothing to disclose

Figures

Figure 1
Figure 1. Signs and symptoms of mediastinitis in pediatric cardiac surgery.
Figure 2
Figure 2. Microbiological profile of cultures in mediastinitis.
See this image and copyright information in PMC

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References

    1. Durandy Y. Mediastinitis in pediatric cardiac surgery Prevention, diagnosis and treatment. World J Cardiol. 2010;2(11):391–398. doi: 10.4330/wjc.v2.i11.391. - DOI - PMC - PubMed
    1. Segers P, De Jong AP, Kloek JJ, Spanjaard L, De Mol BAJM. Risk control of surgical site infection after cardiothoracic surgery. J Hosp Infect. 2006;62(4):437–445. doi: 10.1016/j.jhin.2005.09.028. - DOI - PubMed
    1. Sohn AH, Schwartz JM, Yang KY, Jarvis WR, Guglielmo BJ, Weintrub PS. Risk factors and risk adjustment for surgical site infections in pediatric cardiothoracic surgery patients. Am J Infect Control. 2010;38(9):706–710. doi: 10.1016/j.ajic.2010.03.009. - DOI - PubMed
    1. Barker GM, O´Brien SM, Welke KF, Jacobs ML, Jacobs JP, Benjamin DK, et al. Major Infection After Pediatric Cardiac Surgery A Risk Estimation Model. Ann Thorac Surg. 2010;89(3):843–850. doi: 10.1016/j.athoracsur.2009.11.048. - DOI - PMC - PubMed
    1. Cotogni P. Deep sternal wound infection after cardiac surgery Evidences and controversies. World J Crit Care Med. 2015;4(4):265–273. doi: 10.5492/wjccm.v4.i4.265. - DOI - PMC - PubMed

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