Incidental Gossypiboma Discovered during Tricuspid Valve Re-Repair 11 Years after Ebstein Anomaly Repair

Authors

  • Tornike Sologashvili
  • Afksendiyos Kalangos
  • Cécile Tissot
  • Patrick O. Myers

DOI:

https://doi.org/10.1532/HSF98.20131015

Abstract

Background: A retained surgical sponge, an extremely rare occurrence after cardiac surgery, can trigger a granulomatous reaction and form a sizeable mass or gossypiboma. We report the incidental operative finding of a gossypiboma 11 years after repair of Ebstein anomaly.

Case Report: A 24-year-old man, who had previously undergone tricuspid annuloplasty for Ebstein anomaly 11 years earlier at another institution, was referred for recurrent severe tricuspid regurgitation. During the dissection along the superior vena cava and the right atrium, we entered 2 cystic cavities that exuded a pus-like material, which was sent for culture. Mesh from a retained surgical sponge (gossypiboma) was identified. After complete debridement and administration of vancomycin, the tricuspid valve was repaired. Antibiotics were continued until culture results were confirmed to be negative. The patient's postoperative course was uneventful, and he presented no signs of infection.

Conclusions: We report a rare case of incidentally found gossypiboma after cardiac surgery.

References

Hochhegger B, Zanetti G, Garcia TS, Marchiori E. 2012. Retained surgical sponge presenting as a cardiac mass. Eur J Cardiothorac Surg 41:e129.nKopka L, Fischer U, Gross a J, Funke M, Oestmann JW, Grabbe E. 1996. CT of retained surgical sponges (textilomas): pitfalls in detection and evaluation. J Comput Assist Tomogr 20:919-23.nOkur H, Okur E, Baran R. 2009. Three cases of intrathoracic gossypiboma with varying morbidities depending on the time of detection. Thorac Cardiovasc Surg 57:432-4.nSheehan RE, Sheppard MN, Hansell DM. 2000. Retained intrathoracic surgical swab: CT appearances. J Thorac Imaging 15:61-4.nSugimora H, Tamura S, Kakitsubata Y, et al. 1992. Magnetic resonance imaging of retained surgical sponges. Case report. Clin Imaging 16:259-62.nSzarf G, Mussi de Andrade TC, Nakano E, et al. 2009. Forty-year-old intrathoracic gossypiboma after cardiac valve surgery. Circulation 119:3142-3.nTsutsui JM, Hueb WA, Nascimento SA, Borges Leal SM, De Andrade JL, Mathias W. 2003. Detection of retained surgical sponge by transthoracic and transesophageal echocardiography. J Am Coll Cardiol 16:1191-3.nVayre F, Richard P, Ollivier JP. 1999. Intrathoracic gossypiboma: magnetic resonance features. Int J Cardiol 70:199-200.nWan W, Le T, Riskin L, Macario A. 2009. Improving safety in the operating room: a systematic literature review of retained surgical sponges. Current Opin Anaesth 22:207-14.n

Published

2013-08-19

How to Cite

Sologashvili, T., Kalangos, A., Tissot, C., & Myers, P. O. (2013). Incidental Gossypiboma Discovered during Tricuspid Valve Re-Repair 11 Years after Ebstein Anomaly Repair. The Heart Surgery Forum, 16(4), E216-E218. https://doi.org/10.1532/HSF98.20131015

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