Cannula exchange for refractory cannula infections during Berlin Heart EXCOR support: a case report.
Shota Kawai, Takashi Kido, Motoki Komori et al.
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Case in brief
A 4-year-old girl with truncus arteriosus and severe heart failure received Berlin Heart EXCOR (BHE) support after complex cardiac surgery. Ten months later, methicillin-resistant Staphylococcus epidermidis infected the outflow cannula exit site. Gallium-67 scintigraphy showed uptake along the abdominal cannula tract but no mediastinal extension. Because prior aortic valve closure made temporary BHE explantation infeasible, surgeons exchanged the cannula and performed mediastinal irrigation, omental flap transposition, and negative-pressure wound therapy. The infection resolved completely, with no recurrence during 1-year follow-up.
What made this case unusual
Prior aortic valve closure precluded temporary BHE explantation, prompting cannula exchange with omental flap transposition as an alternative surgical approach for refractory infection.
Diagnostic / clinical pearl
Gallium-67 scintigraphy can delineate cannula-tract involvement and assess for mediastinal extension in suspected BHE cannula infection.
Why it matters
The case describes a surgical option when refractory cannula infection requires intervention but temporary device explantation is not feasible.