{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:26:55Z","timestamp":1781328415172,"version":"3.54.1"},"reference-count":5,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T00:00:00Z","timestamp":1712275200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T00:00:00Z","timestamp":1712275200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006356","name":"University of Southern Denmark","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006356","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Cardiopulmonary bypass induces a systemic inflammatory response and alterations in fluid homeostasis, resulting in generalized tissue edema. Additionally, ischemia-reperfusion injury following cardioplegic arrest presumably prompts organ-specific myocardial edema.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>The case report presents a 75-year-old Caucasian male diagnosed with aortic dissection, Stanford type A, who underwent complicated open-heart surgery. Postoperatively, the patient developed excessive myocardial edema, particularly affecting the right ventricle myocardium to an extent where the right ventricle surpassed the sternal rim, making it impossible to close the sternum. Ischemia was ruled out by performing coronary angiography, demonstrating well-calibrated coronary arteries. Transoesophageal echocardiography showed a restrictive right ventricle with free-wall thickness of 30\u00a0mm, severely reduced right ventricle systolic function and a volume-depleted left ventricle consistent with right ventricular heart failure due to right ventricular edema. The patient presented with unstable haemodynamics despite use of inotropes and continuation of open sternotomy. In an attempt to reduce myocardial edema, the patient was started on corticosteroid treatment despite of ongoing mediastinitis. Corticosteroid treatment reduced myocardial edema and enabled the closure of sternum on the 44th postoperative day.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The case report addresses the clinical relevance of corticosteroid treatment in selective cases of intractable haemodynamically significant postoperative myocardial edema.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13019-024-02656-4","type":"journal-article","created":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T09:02:01Z","timestamp":1712307721000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Right ventricular myocardial edema leading to severe heart failure after open heart surgery \u2013 possible effect of high-dose corticosteroid therapy"],"prefix":"10.1186","volume":"19","author":[{"given":"Karoline Korsholm","family":"Jeppesen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars Peter","family":"Riber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi Sanchez","family":"Dahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,5]]},"reference":[{"key":"2656_CR1","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1053\/jcan.2001.26537","volume":"15","author":"RS Adsumelli","year":"2001","unstructured":"Adsumelli RS, Shapiro JR, Shah PM, Martella AT, Afifi AY, Risher WB, Hicks GL. Hemodynamic effects of chest closure in adult patients undergoing cardiac surgery. J Cardiothorac Vasc Anesth. 2001;15:589\u201392.","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"2656_CR2","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1111\/j.1540-8191.2010.01159.x","volume":"26","author":"U Boeken","year":"2011","unstructured":"Boeken U, Feindt P, Schurr P, Assmann Alexander, Akhyari P, Lichtenberg A. Delayed sternal closure (DSC) after cardiac surgery: outcome and prognostic marker. J Card Surg. 2011;26:22\u20137.","journal-title":"J Card Surg"},{"key":"2656_CR3","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.jcrc.2019.12.006","volume":"56","author":"NAM Dekker","year":"2020","unstructured":"Dekker NAM, van Leeuwen ALI, van de Ven PM, de Vries R, Hordijk PL, Boer C, van den Brom CE. Pharmacological interventions to reduce edema following cardiopulmonary bypass: a systematic review and meta-analysis. J Crit Care. 2020;56:63\u201372.","journal-title":"J Crit Care"},{"key":"2656_CR4","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1016\/S0140-6736(15)00273-1","volume":"386","author":"RP Whitlock","year":"2015","unstructured":"Whitlock RP, Devereaux PJ, Teoh KH, Lamy A, Vincent J, Pogue J, Paparella D, Sessler DI, Karthikeyan G, Villar JC, Zuo Y, Avezum A, Quantz M, Tagarakis GI, Shah PJ, Abbasi SH, Zheng H, Pettit S, Chrolavicius S, Yusuf S. SIRS investigators. Methylprednisolone in patients undergoing cardiopulmonary bypass (SIRS): a randomized, double-blind, placebo-controlled trial. Lancet. 2015;386:1243\u201353.","journal-title":"Lancet"},{"key":"2656_CR5","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1016\/S0022-5223(03)01028-6","volume":"127","author":"M Farstad","year":"2004","unstructured":"Farstad M, Heltne JK, Rynning SE, Onarheim H, Mongstad A, Eliassen F, Husby P. Can the use of methylprednisolone, vitamin c, or alpha-trinositol prevent cold-induced fluid extravasation during cardiopulmonary bypass in piglets. J Thorac Cardiovasc Surg. 2004;127:525\u201334.","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-024-02656-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-024-02656-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-024-02656-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T09:02:56Z","timestamp":1712307776000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/s13019-024-02656-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,5]]},"references-count":5,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2656"],"URL":"https:\/\/doi.org\/10.1186\/s13019-024-02656-4","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,5]]},"assertion":[{"value":"3 June 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 April 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Ethical Committee of Southern Denmark waived need for approval.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed oral and written consent was obtained from the patient.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"179"}}