Endocarditis at prior venous cannulation site after sternal wound
infection: Case Report
Abstract
Endocarditis originating from a prior venous cannulation site is
undescribed in the current literature. Infections of the heart pose
significant morbidity and mortality to patients, therefore prompt
recognition, diagnosis, and treatment are critical. Our patient
underwent coronary artery bypass grafting (CABG) and developed a
postoperative sternal wound infection with methicillin resistant
staphylococcus aureus (MRSA). After failing nonoperative management,
redo-sternotomy was performed with atrial wall debridement and patch
repair. During this procedure, two unexpected small discrete abscess
pockets of the right atrial epicardium were discovered. One of the
abscess pockets fistulized into the right atrium and was noted to be at
his prior venous cannulation site for cardiopulmonary bypass as
evidenced by neighboring prolene suture. The patient had an uneventful
recovery and was discharged home on postoperative day 7. Transthoracic
echo was obtained 6 weeks after his second operation and did not show
any recurrence of endocarditis. We present a unique case of persistent
cardiac infection with a complicated course and management strategy.