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When surgical option is not provided: a successful multidisciplinary approach to a refractory case of sternal osteomyelitis following coronary surgery

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Abstract

Purpose

Sternal osteomyelitis is a major complication of cardiac operations performed through median sternotomy. The surgical treatment, which involves the debridement and removal of whole infected and necrotic tissue is the standard of care, although it is sometimes unachievable. This may occur, for instance, when the infectious-inflammatory process invades the anterior mediastinum and tenaciously incorporates one or more of vital anatomical structures.

Methods and results

An inoperable case of postoperative sternal osteomyelitis that involved the right ventricle and the right coronary artery, and that was successfully treated using a nonsurgical multidisciplinary approach, is reported here.

Conclusion

For highly selected patients with sternal osteomyelitis for whom surgery is a too risky option, an approach including the contribution of various specialists might be a viable way out.

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Funding

This report received no funding.

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Authors and Affiliations

  1. Division of Cardiac Surgery, Cardio-Thoraco-Vascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), Ospedale di Cattinara, University of Trieste, Via Pietro Valdoni, 7, 34148, Trieste, Italy

    Giuseppe Gatti & Enzo Mazzaro

  2. Hyperbaric Medicine Unit, Department of Anesthesia and Intensive Care, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy

    Paola Amato

  3. Department of Nuclear Medicine, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy

    Franca Dore & Carmelo Crisafulli

  4. Radiology Unit, Department of Medicine, Surgery and Health Sciences, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy

    Manuel Belgrano

  5. Department of Infective Diseases, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy

    Cristina Maurel & Roberto Luzzati

  6. Microbiology Unit, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy

    Venera Costantino

Authors
  1. Giuseppe Gatti
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  2. Paola Amato
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  3. Franca Dore
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  4. Carmelo Crisafulli
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  5. Manuel Belgrano
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  6. Cristina Maurel
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  7. Venera Costantino
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  8. Roberto Luzzati
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  9. Enzo Mazzaro
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Contributions

All authors whose names appear on the submission: 1. made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work; 2. drafted the work or revised it critically for important intellectual content; 3. approved the version to be published; and 4. agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Giuseppe Gatti.

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Competing interests

The authors declare no competing interests.

Ethical approval

Internal Review Board of Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI) approved publication of the present case report. The patient gave full written consent to publish, in anonymous format, all clinical data concerning the present report.

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Gatti, G., Amato, P., Dore, F. et al. When surgical option is not provided: a successful multidisciplinary approach to a refractory case of sternal osteomyelitis following coronary surgery. Infection 52, 265–269 (2024). https://doi.org/10.1007/s15010-023-02119-3

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  • DOI: https://doi.org/10.1007/s15010-023-02119-3

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