General Thoracic and Cardiovascular Surgery Cases最新文献

{"title":"Primary lung cancer with delayed drug-induced interstitial lung disease after neoadjuvant chemoimmunotherapy: a case report.","authors":"Hideomi Ichinokawa, Takashi Sowa, Takashi Yaguchi, Yukio Watanabe, Kazuya Takamochi, Kenji Suzuki","doi":"10.1186/s44215-026-00247-4","DOIUrl":"10.1186/s44215-026-00247-4","url":null,"abstract":"<p><p>BACKGROUND: Neoadjuvant chemoimmunotherapy is becoming a mainstream treatment for primary lung cancer; however, delayed immune-related adverse events occurring at 3 months or more after discontinuation of treatment have not been reported in this patient population. CASE PRESENTATION: A 64-year-old man underwent bronchoscopic biopsy, revealing a lung adenocarcinoma (cT4N0M0, stage IIIA), and was treated with three courses of carboplatin, pemetrexed, and nivolumab as neoadjuvant chemoimmunotherapy. Four months after the first course of treatment, the patient underwent a left upper lobectomy with lymph node dissection. Although postoperative hoarseness occurred as a complication, he was discharged on postoperative day 12. On postoperative day 56, the patient developed shortness of breath. An increased inflammatory response and infiltrates in the right lower lobe suggested aspiration pneumonia; however, his condition failed to improve after 1 week of antibiotic therapy. Elevated KL-6 levels and worsening of a right lower lobe interstitial shadow were observed. On day 104 after immunotherapy, the patient was diagnosed with delayed drug-induced interstitial lung disease, and steroid therapy resulted in improvement. CONCLUSIONS: In patients with a history of immune checkpoint inhibitor (ICI) administration, attention must be paid to the occurrence of immune-related adverse events, regardless of the duration of ICI administration or the time elapsed since discontinuation, and when diagnosed, treatment should be initiated immediately in accordance with guidelines. </p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":" ","pages":"7"},"PeriodicalIF":0.4,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified bentall surgery using a graft insertion technique for prosthetic valve endocarditis with left ventricular-aortic discontinuity: a case report.","authors":"Daichi Sakurahara, Eisaku Nakamura, Kosuke Mori, Koji Furukawa","doi":"10.1186/s44215-026-00243-8","DOIUrl":"10.1186/s44215-026-00243-8","url":null,"abstract":"<p><p>BACKGROUND: Infective prosthetic valve endocarditis is a life-threatening condition with high morbidity and mortality; it is often complicated by periannular abscesses and left ventricular–aortic (LV–Ao) discontinuity. These situations make standard valve or root replacement technically challenging and require complex reconstructive procedures. CASE PRESENTATION: We report a 59-year-old man with a history of hemiarch replacement and aortic valve replacement for acute Stanford type A dissection. He presented with fever and heart failure symptoms. Imaging revealed severe prosthetic valve regurgitation, periannular abscess, pseudoaneurysm, and LV–Ao discontinuity. Urgent surgery was performed. After complete debridement, the LV outflow tract was reconstructed using the graft insertion technique (GIT) with a Gelweave Valsalva graft and composite graft replacement. The coronary arteries were reconstructed with short interposition grafts. Postoperatively, antibiotics were continued; a permanent pacemaker was implanted for complete atrioventricular block; and the patient was discharged on postoperative day 54. At 1-year follow-up, he remained free of recurrent infection. CONCLUSIONS: The GIT facilitates secure fixation, reliable hemostasis, and reproducible reconstruction even in fragile, infected tissue. Although potential risks, including conduction disturbance and graft infection remain, the method is technically straightforward and can be applied during emergencies. In the case presented here, this approach resulted in satisfactory early outcomes, highlighting the applicability of graft insertion for managing LV–Ao discontinuity in a patient with prosthetic valve endocarditis, particularly when preparation time and graft availability are limited. </p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"5 1","pages":"6"},"PeriodicalIF":0.4,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12896058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146184040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life-saving left completion pneumonectomy for lung abscess due to Pseudomonas aeruginosa: a case report.","authors":"Shorin Matsumoto, Noriko Hiyama, Kento Fukumoto, Tomoki Tamura, Hiroshi Goto, Jun Matsumoto","doi":"10.1186/s44215-026-00242-9","DOIUrl":"10.1186/s44215-026-00242-9","url":null,"abstract":"<p><p>BACKGROUND: Pseudomonas aeruginosa is typically an opportunistic pathogen but, on rare occasions, may cause community-acquired pneumonia in healthy adults, often resulting in rapid and severe clinical deterioration. This case report details the successful management of a P. aeruginosa-induced community-acquired lung abscess in a patient who had fully returned to normal daily life 1 year and 5 months after a left upper lobectomy. CASE PRESENTATION: A 63-year-old woman underwent video-assisted thoracoscopic left upper lobectomy with lymph node dissection for lung squamous cell carcinoma 1 year and 5 months prior. She received four courses of adjuvant chemotherapy postoperatively and remained recurrence-free. The patient presented with cough and fever and was diagnosed with a pulmonary abscess characterized by extensive infiltrative shadowing with cavitation in the left lower lobe. She developed septic shock requiring vasopressor support. On hospital day 3, worsening pulmonary infiltrates and altered consciousness prompted an emergency left completion pneumonectomy for infection source control, as antibiotic therapy alone was insufficient. Postoperative culture confirmed Pseudomonas aeruginosa. Although two subsequent hematoma evacuations and drainage were required, the patient recovered and was discharged on postoperative day 39. CONCLUSION: We present a rare case of P. aeruginosa community-acquired lung abscess complicated by septic shock. In rapidly progressive cases, early consideration of P. aeruginosa infection, prompt administration of antibiotics with anti-P. aeruginosa activity, and early assessment for surgical intervention may improve patient outcomes. </p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":" ","pages":"5"},"PeriodicalIF":0.4,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12896097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-mucinous, enteric-type thymic adenocarcinoma: genetic analysis of a case.","authors":"Eiji Narusawa, Yoichi Ohtaki, Genichiro Ishii, Seshiru Nakazawa, Natsuko Kawatani, Tomohiro Yazawa, Kazuki Numajiri, Yuka Yoshida, Keisuke Nimura, Ken Shirabe","doi":"10.1186/s44215-026-00240-x","DOIUrl":"10.1186/s44215-026-00240-x","url":null,"abstract":"<p><strong>Background: </strong>Thymic adenocarcinoma is a rare histological subtype of thymic carcinoma. Non-mucinous enteric-type thymic adenocarcinomas are extremely rare.</p><p><strong>Case presentation: </strong>A 54-year-old woman with an abnormality detected on chest radiography was admitted to our hospital. Chest computed tomography showed a 5.5-cm-diameter mass in the anterior mediastinum. Blood carcinoembryonic antigen (CEA) level was highly elevated at 127 ng/ml (normal < 5), while other tumor markers, including alpha-fetoprotein, β-human chorionic gonadotropin, and interleukin-2R levels, were normal. Radiological findings suggested that the tumor was a thymic epithelium (Masaoka stage III). Surgery is performed for diagnostic and therapeutic purposes. Intraoperative findings revealed extensive pericardial invasion requiring a median sternotomy. The left brachiocephalic vein, pericardium, and lungs were resected along with the tumor to achieve complete resection. Histological findings revealed that the tumor was composed of tall, columnar adenocarcinoma forming irregular lumina with no mucin production. Immunohistochemistry showed that cytokeratin 20 was partially positive and caudal type homeobox 2 was positive in approximately 50% of the tumor cells. Based on the morphological and immunohistochemical findings, enteric-type thymic adenocarcinoma was diagnosed per the 5th edition of the World Health Organization classification. The tumor was subtyped according to the Masaoka (stage IVB) and TNM classification criteria (T3N1M0 stage IVA). Plasma CEA levels decreased to normal levels after surgery. Further genetic analysis of the tumor revealed a pathogenic TP53 stop-gain mutation (p.Arg213*), leading to the loss of p53 protein function. Postoperative adjuvant radiation therapy (54 Gy in 27 fractions) was administered under the suspicion of incomplete microscopic resection. Reportedly, the patient is in complete remission four years post-surgery.</p><p><strong>Conclusions: </strong>We encountered a rare case of non-mucinous enteric-type thymic adenocarcinoma harboring a pathogenic TP53 mutation. Further studies are required to enunciate the features of this subtype of thymic carcinoma.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative voltage mapping-assisted resection of a giant right ventricular giant tumor: a case report.","authors":"Takehiro Nakajima, Shun-Ichiro Sakamoto, Ryo Maekawa, Anna Tsuji, Motohiro Maeda, Kenji Suzuki, Jiro Honda, Norio Motoda, Tetsuro Sekine, Yosuke Ishii","doi":"10.1186/s44215-025-00239-w","DOIUrl":"10.1186/s44215-025-00239-w","url":null,"abstract":"<p><p>BACKGROUND: Cardiac hemangiomas located in the right heart can lead to serious complications, including right ventricular outflow tract (RVOT) obstruction, arrhythmias, and sudden cardiac death. Although surgical resection remains the primary treatment, complete excision of intramural tumors poses risk of impairing cardiac function. This case report describes the successful resection of a large right ventricular hemangioma using intraoperative voltage mapping, which enable maximal tumor removal while preserving myocardial integrity and preventing postoperative heart failure. CASE PRESENTATION: A 76-year-old female underwent a routine health examination in July 2024, during which cardiomegaly and nonspecific ST-segment changes were detected on electrocardiography. Contrast enhanced computed tomography revealed a well-defined 60 mm mass within the right ventricle, causing significant ROVT stenosis. No evidence of distant metastasis or elevated tumor markers was detected. The patient underwent tumor resection via median sternotomy. Intraoperative voltage mapping was utilized to delineate viable myocardium at the tumor margins. The tumor was excised while preserving functional myocardial tissue. Cryoablation was performed at the resection margins, and resultant defect in the right ventricular wall was reconstructed using a bovine pericardial patch. Histopathological analysis confirmed the diagnosis of cardiac hemangioma. The patient experienced an uneventful postoperative course had no postoperative complications and was discharged on postoperative day 16. Preoperative and postoperative cardiac magnetic resonance imaging demonstrated preserved right ventricular function. CONCLUSIONS: Intraoperative voltage mapping proved to be a valuable adjunct in the surgical management of right ventricular tumors, enabling effective tumor resection while preserving myocardial tissue and maintaining postoperative cardiac function. </p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":" ","pages":"4"},"PeriodicalIF":0.4,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12896158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145992820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthotopic heart transplantation for Fontan failure: experience and treatment strategy-a case report.","authors":"Sakura Horie, Fumiaki Shikata, Yasutaka Hirata, Shigeto Tsuji, Sadayuki Moriyama, Masahiko Ando, Ryo Inuzuka, Hideyuki Kato, Minoru Ono","doi":"10.1186/s44215-025-00234-1","DOIUrl":"10.1186/s44215-025-00234-1","url":null,"abstract":"<p><strong>Background: </strong>Orthotopic heart transplantation after the Fontan operation presents technical surgical challenges due to the connection of systemic veins to pulmonary arteries and well-developed systemic-to-pulmonary collateral arteries. The altered anatomy and hemodynamics necessitate extensive vascular reconstruction. We report a successful orthotopic heart transplantation with three years of ventricular assist device (VAD) support in a child who had undergone the Fontan operation.</p><p><strong>Case presentation: </strong>A 10-year-old boy had undergone extracardiac total cavopulmonary connection (18 mm expanded polytetrafluoroethylene conduit) at 2 years of age for a large ventricular septal defect, straddling tricuspid valve, and mitral stenosis. Following the Fontan operation, his systemic ventricular function gradually deteriorated. At 7 years of age, a Berlin Heart EXCOR® Pediatric VAD was implanted due to progressive heart failure, and he was listed for heart transplantation. Three years later, a heart transplant was performed. Cardiopulmonary bypass was established via cervical cannulation before re-sternotomy. The superior vena cava and extracardiac conduit were detached from the pulmonary artery. The pulmonary artery was reconstructed from hilum to hilum with a large bovine pericardial patch. Well-developed systemic-to-pulmonary collaterals caused excessive left atrial return; therefore, the left atrial anastomosis was performed under deep hypothermic circulatory arrest. The systemic veins were reconstructed with bicaval anastomosis, and inferior vena caval continuity was restored by leaving a short segment of the previous conduit. The procedure was completed without complications. Postoperative recovery was uneventful, and the patient was discharged on day 35.</p><p><strong>Conclusions: </strong>This case illustrates a successful approach to orthotopic heart transplantation in a child with failing Fontan circulation supported by a VAD. Reconstruction of the pulmonary artery using a large pericardial patch and restoration of bicaval continuity were key to overcoming complex anatomical challenges.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"5 1","pages":"2"},"PeriodicalIF":0.1,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12781744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful surgical resection of infective endocarditis involving the left ventricular outflow tract and sigmoid septum.","authors":"Tomonori Sano, Kazuma Handa, Masaru Ishida, Toshinari Onishi, Keiij Iwata","doi":"10.1186/s44215-025-00238-x","DOIUrl":"10.1186/s44215-025-00238-x","url":null,"abstract":"<p><p>BACKGROUND: Vegetation in the left ventricular outflow tract (LVOT) due to infective endocarditis (IE) is extremely rare, and no previous reports have described vegetation on the sigmoid septum. We report a rare case of IE with vegetation attached to the sigmoid septum in the LVOT that was successfully managed by surgical resection. CASE PRESENTATION: An 80-year-old woman was admitted with an acute cerebral infarction and fever. Transesophageal echocardiography revealed highly mobile vegetation attached to the sigmoid septum in the LVOT, and blood cultures were positive for Streptococcus agalactiae. Due to the high risk of further embolization, surgical resection was performed using a transaortic approach. The vegetation was easily removed under direct visualization, and the histopathological findings were consistent with IE. The patient’s postoperative course was uneventful, and antibiotic therapy was continued. CONCLUSIONS: Vegetations in the LVOT carry a significant risk of embolic events and potential LVOT obstruction. A transaortic approach allows for safe and effective removal under good visualization. Early surgical intervention should be considered in similar cases. </p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":" ","pages":"3"},"PeriodicalIF":0.4,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12849307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated thymic metastasis of breast cancer 10.5 years after surgery: a case report.","authors":"Makoto Tomoyasu, Wataru Shigeeda, Yuka Kaneko, Ryuichi Yoshimura, Hironaga Kanno, Ryotaro Endo, Hiroyuki Deguchi, Hajime Saito","doi":"10.1186/s44215-025-00236-z","DOIUrl":"10.1186/s44215-025-00236-z","url":null,"abstract":"<p><strong>Background: </strong>As breast cancer grows slowly, recurrences more than 10 years after surgery are not uncommon. However, isolated metastasis to the thymus without extra-mediastinal lesions is extremely rare.</p><p><strong>Case presentation: </strong>A 51-year-old woman underwent right mastectomy for right breast cancer 10.5 years ago. Following surgery, she received adjuvant chemotherapy, radiotherapy, and 10 years of anti-estrogen therapy, with no evidence of recurrence during that period. However, due to a slow upward trend in carcinoembryonic antigen levels, PET imaging was performed and revealed an irregular tumor measuring 20 × 27 × 75 mm in diameter. This consisted of both cystic and solid components, and was located within the thymus, just above the left brachiocephalic vein, with an abnormal 18 F-fluorodeoxyglucose uptake. The tumor was confined to the thymus, with no lesions were detected in the lungs or any other organs. Differential diagnoses included thymic hyperplasia, thymoma, thymic carcinoma, and malignant lymphoma. We performed thymectomy via median sternotomy for both diagnosis and treatment. Immunohistochemical staining confirmed isolated thymic metastasis of breast cancer. The patient is currently being treated postoperatively with aromatase inhibitor and cyclin-dependent kinase 4/6 inhibitor.</p><p><strong>Conclusion: </strong>We present a surgical case of an extremely rare asynchronous, isolated thymic metastasis that occurred over 10 years after initial breast cancer surgery. This case underscores the importance of considering thymic metastasis in the differential diagnosis of anterior mediastinal tumors in patients with a remote history of breast cancer.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":" ","pages":"1"},"PeriodicalIF":0.1,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12771870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation-based activated clotting time targeting for cardiopulmonary bypass in patients with antiphospholipid syndrome: two case reports.","authors":"Yuki Kamikawa, Yosuke Saito, Hiromi Fujii, Yoichiro Machida, Hiroaki Hata, Hirotaka Inaba","doi":"10.1186/s44215-025-00235-0","DOIUrl":"10.1186/s44215-025-00235-0","url":null,"abstract":"<p><strong>Background: </strong>Antiphospholipid syndrome (APS) is an autoimmune prothrombotic disorder that is frequently associated with systemic lupus erythematosus (SLE). Cardiac surgery in patients with APS presents unique challenges because activated clotting time (ACT) monitoring can be unreliable, frequently yielding falsely prolonged results due to the presence of lupus anticoagulant. Although heparin concentration-based monitoring is more accurate, devices such as the Hemostasis Management System Plus have been discontinued, creating a gap in practical anticoagulation management.</p><p><strong>Case presentation: </strong>We report two female patients with APS and severe aortic regurgitation (AR) who underwent aortic valve replacement (AVR) under cardiopulmonary bypass (CPB). Case 1: A 58-year-old woman with long-standing SLE and APS underwent preoperative ACT simulation using her serum mixed with a 60 U/mL heparin solution to estimate the ACT corresponding to a heparin concentration of 3.0 U/mL. The resulting ACT range (567-708 s) guided intraoperative anticoagulation. AVR with a mechanical valve and left atrial appendage amputation (LAAA) was performed. Protamine was administered at half the calculated dose. Postoperative bleeding was transient and well controlled. Case 2: A 62-year-old woman with recent APS, deep vein thrombosis, and infective endocarditis underwent ACT simulation. The simulated ACT ranged from 325 to 413 s, and an intraoperative ACT target of > 450 s was established. AVR and LAAA were performed uneventfully with half dose protamine. No thrombotic or bleeding complications occurred.</p><p><strong>Discussion: </strong>These cases highlight the limitations of conventional ACT monitoring in patients with APS and demonstrate the utility of individualized preoperative ACT simulation as a practical alternative. This approach allowed safe anticoagulation management without requiring advanced equipment. Reduced protamine dosing likely minimized the risk of rebound hypercoagulability, a concern in APS. Notably, despite identical heparin concentrations, ACT responses varied among the patients, underscoring the need for personalized strategies.</p><p><strong>Conclusion: </strong>Preoperative ACT simulation using patient serum offers a practical, accessible, and individualized method for guiding anticoagulation therapy in patients with APS undergoing cardiac surgery. This technique may enhance perioperative safety in resource-limited settings, and warrants further validation in larger cohorts.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"4 1","pages":"49"},"PeriodicalIF":0.1,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of topical application of taurolidine 2% in promoting second intention healing of poststernotomy deep incisional wound infection.","authors":"Roberto Cemin, Michela Coronet, Andrea Azzolini, Cinzia Viola, Carmen Ladurner, Andrea Comunello, Benito Baldauf","doi":"10.1186/s44215-025-00237-y","DOIUrl":"10.1186/s44215-025-00237-y","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infections following median sternotomy are common and can lead to extended hospital stays, prolonged courses of intravenous antibiotics, increased healthcare costs, and, in many cases, the need for repeated debridement or additional surgical interventions. Recognizing this significant unmet clinical need, we adopted an alternative approach in the present case report to address and resolve the problem.</p><p><strong>Case presentation: </strong>We herein report a case of a 52-year-old female patient, that developed a deep incisional infection with localized dehiscence after a median sternotomy performed for left atrial myxoma removal. Klebsiella aerogenes was cultured from the wound swabs and, despite prolonged intravenous antibiotic therapy and regular debridement we were unable to obtain culture negativity or wound healing over the course of several weeks. A commercially available Taurolidine 2% solution was employed every other day to irrigate the wound, which led to culture negativity within five days. Complete reepithelization was reached after a total of five weeks.</p><p><strong>Conclusion: </strong>Reports of various taurolidine solutions promoting healing in complex wound lesions are scarcely available. In our case it proved to be an effective therapeutic option, preventing the need for additional surgical intervention and facilitating healing by secondary intention.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"4 1","pages":"50"},"PeriodicalIF":0.1,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}