[Initial and Long-term Results of Omental Flap Coverage for the Complications after Thoracic Aortic Aneurysm Repair].

OBJECTIVE

Here, we will review the initial remote results of omental flap coverage (OFC) after thoracic aortic aneurysm repair and report on its efficacy and problems.

METHODS

We performed 567 thoracic aortic aneurysm surgeries from January 2007 to December 2021, including OFC in 16 patients( 2.8%, 10 males, mean age 65 years:range 30-82 years) who underwent OFC.

RESULTS

OFC was performed in 14 cases of mediastinitis and 2 cases of perigraft seroma. 13 cases were performed at the same admission as the initial surgery, and 3 cases were performed after the discharge. The causative organisms of mediastinitis were methicillin-resistant Staphylococcus aureus (MRSA) in 4 cases, methicillin-resistant coagulase negative Staphylococcus( MRCNS) in 2 cases, Staphylococcus, Acinetobacter, Klebsiella, and methicillin-resistant Staphylococcus epidermidis( MRSE) in 1 case each, and unknown in 4 cases. All cases underwent successful reoperation with OFC alone, except in 1 case in which redo root replacement was performed for an anastomotic pseudoaneurysm. The overall hospital mortality was 31% (4 cases for MOF, 1 case for anastomotic hemorrhage). Of the 11 patients who were discharged alive, two died remotely (heart failure, senility), and no cases of reinfection were encountered.

CONCLUSION

OFC is an effective treatment not only for mediastinitis but also for perigraft seroma while significantly reducing the risk of reinfection.