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Late outcome after surgical and topical treatment for Aspergillus mediastinitis after heart transplantation
  • +5
  • Paul Vogt,
  • Raed Aser,
  • Daniel Schmidlin,
  • Paul Mohacsi,
  • Pascal Berdat,
  • Philip Went,
  • Markus Flepp,
  • Carlos Mestres
Paul Vogt
Hirslanden Klinik im Park
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Raed Aser
UniversitätsSpital Zürich
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Daniel Schmidlin
Hirslanden Klinik im Park
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Paul Mohacsi
Hirslanden Klinik im Park
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Pascal Berdat
Hirslanden Klinik im Park
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Philip Went
Kantonsspital Graubünden
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Markus Flepp
Hirslanden Klinik im Park
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Carlos Mestres
University Hospital Zurich
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Abstract

Here we report the seven-year long-term survival after Aspergillus fumigatus mediastinitis after heart transplantation, an uncommonly described condition. A 66-year-old male developed infection with A. fumigatus covering the entire thoracic cavity with a fungal turf after orthotopic heart transplantation. Repeated surgical removal of infectious and necrotic tissue together with innovative topical treatment using voriconazole and chlorhexidine combined with systemic antifungal treatment lead to control of infection. Definitive wound closure was achieved by standard sternal refixation and latissimus dorsi muscle flap plasty. Survival after A. fumigatus mediastinitis after heart transplantation was achieved with sequential debridement in combination with topical application of antifungal agents.

Peer review status:ACCEPTED

27 Oct 2020Submitted to Journal of Cardiac Surgery
29 Oct 2020Submission Checks Completed
29 Oct 2020Assigned to Editor
03 Nov 2020Reviewer(s) Assigned
23 Nov 2020Review(s) Completed, Editorial Evaluation Pending
09 Dec 2020Editorial Decision: Revise Major
04 Jan 20211st Revision Received
05 Jan 2021Submission Checks Completed
05 Jan 2021Assigned to Editor
15 Jan 2021Reviewer(s) Assigned
18 Jan 2021Review(s) Completed, Editorial Evaluation Pending
09 Feb 2021Editorial Decision: Accept