Lethal cardiac tamponade due to aortotomy wound dehiscence after cardiac valve replacement (CVR) are apparently unreported in the recent literature. An uncommon example of delayed non-valvular lethal complication of CVR occurring in the early out-patient period is reported here.
The forensic aspects of wound dehiscence in cardiovascular surgery for cardiac valve replacement are discussed, and complemented by a study of the fracture ends of suture material in wound breakdown associated with the suture failure.
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References
1.
EdmundsL. H.ClarkR. E.CohnL. H.MillerD. C.WeiseLR. D. (1988) Guidelines for reporting morbidity and mortality after cardiac valve operations. J. Thorac. Cardiovasc. Surg.96, 351–3.
2.
ForesmanP. A.EdlichR. F.RodeheaverG. T. (1989) The effect of new monofilament absorbable sutures on the healing of musculoaponeurotic incisions, gastrotomies and colonic anastomoses. Arch. Surg.124, 708–10.
3.
Gonzales-LavinL.Gonzales-LavinJ.McGrathL. B.AminiS.GrafD. (1989) Factors determining in-hospital or late survival after aortic valve replacement. Chest95, 38–42.
4.
HardyM. A. (1989) The biology of scar formation. Phys. Ther.69, 1014–24
5.
HawleyD. A.KennedyJ. C.PlessJ. E.GaugerD. W.WallerB. F. (1988) Cardiac injury during valve replacement surgery. J. For. Sci.33, 276–82.
6.
LytleB. W.CosgroveD. M.TaylorP. C.. (1989) Primary isolated aortic valve replacement. Early and late results. J. Thorac. Cardiovasc. Surg.97, 675–94.
7.
NashefS. A.MarshallA. J.BainW. H. (1989) Care of patients with prosthetic heart valves. Update15 June, 1373–80.
8.
RobertsW. C. (1982) Complications of cardiac valve replacement: characteristic abnormalities of prostheses pertaining to any or specific sites. Am. Heart J.103, 113–22.
9.
RobertsW. C.MorrowA. G. (1967) Causes of early postoperative death following cardiac valve replacement. Clinico-pathological correlation in 64 patients studied at necropsy. J. Thorac. Cardiovasc. Surg.54, 422–37.
10.
WilliamsP. L.WarwickR.DysonM.BannisterL. H. (1989) The integument. Wound healing in skin. In: ibidem, eds. Gray's Anatomy. Churchill Livingstone, Edinburgh.
