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Lymphocele formation is a rare complication after surgical procedures involving the mediastinum. While uncomplicated lymphoceles show high rates of spontaneous closure and are usually treated conservatively, surgical treatment might be required in cases with persistent or recurrent lymphoceles. We present the case of a 53-year-old male with reoccurring cervical swelling after two surgeries of the thoracic aorta. After 1.5 years, the swelling occurred for the first time and appeared for the next 2 years repeatedly without clinical or laboratory signs of infection. A cervical lymphocele was suspected, and the decision for surgical revision was made. Fibrin glue was applied to the potential leakage of the thoracic duct, and the cavity was filled with a free omental flap. This resulted in a complete regression of the swelling. [ABSTRACT FROM AUTHOR]

Background: Mitral valve infective endocarditis (IE) still has a high mortality. Minimally invasive mitral valve surgery (MIMVS) is technically more challenging, especially in patients with endocarditis. Here, we compare the early postoperative outcome of patients with endocarditis and other indications for MIMVS. Methods: Two groups were formed, one consisting of patients who underwent surgery because of mitral valve endocarditis (IE group: n = 75) and the other group consisting of patients who had another indication for MIMVS (non-IE group: n = 862). Patients were observed for 30 postoperative days. Data were retrospectively reviewed and collected from January 2011 to September 2023. Results: Patients from the IE group were younger (60 vs. 68 years; p < 0.001) and had a higher preoperative history of stroke (26% vs. 6%; p < 0.001) with neurological symptoms (26% vs. 9%; p < 0.001). No difference was seen in overall surgery time (211 vs. 206 min; p = 0.71), time on cardiopulmonary bypass (137 vs. 137 min; p = 0.42) and aortic clamping time (76 vs. 78 min; p = 0.42). Concerning postoperative data, the IE group had a higher requirement of erythrocyte transfusion (2 vs. 0; p = 0.041). But no difference was seen in the need for a mitral valve redo procedure, bleeding, postoperative stroke, cerebral bleeding, new-onset dialysis, overall intubation time, sepsis, pacemaker implantation, wound healing disorders and 30-day mortality. Conclusions: Minimally invasive mitral valve surgery in patients with mitral valve endocarditis is feasible and safe. Infective endocarditis should not be considered as a contraindication for MIMVS. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to review a multicenter experience of patients undergoing surgical intervention for infective endocarditis caused by Cutibacterium acnes and to analyze the diagnostic challenges and operative results., Methods: We retrospectively reviewed 8812 patients undergoing cardiac surgery for endocarditis at 12 cardiac surgical departments across Germany. The overall population was divided based on the type of endocarditis (ie, native and prosthetic valve endocarditis). Primary outcomes were in-hospital mortality, 1- and 5-year survival., Results: C. acnes caused endocarditis in 269 patients (3.1%). Median age was 65 years (54-72 years) and 237(88.1%) were male. We observed significantly higher rates of native valve endocarditis in patients aged 21-40, whereas prosthetic valve endocarditis was more frequent in all other age groups (p < 0.001). The median EuroSCORE II of the cohort was 10.7 (5.0-29.6), with it being significantly higher in the prosthetic valve endocarditis group (p < 0.001). Blood culture negative infective endocarditis was initially reported in 54.3% of the patients. The in-hospital mortality was comparable between the groups (p = 0.340). Survival at one and five years was significantly higher in the native valve endocarditis group (p < 0.001)., Conclusions: Cutibacterium acnes causes native valve endocarditis especially in younger patients. The incidence of endocarditis caused by C. acnes is alarming and is at par with well-known endocarditis pathogens such as the HACEK group. The pathogen has a low virulence and presents with a rather indolent course. The diagnosis of C. acnes endocarditis is challenging and requires a multimodal specialized approach. Surgical treatment is associated with acceptable outcomes., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)