[Mediastinal infection following open heart surgery].
31 cases of mediastinal infection occurred in 7164 patients who had undergone open heart surgery under CPB were reviewed in the period of 1981-1989. The over-all incidence was 0.43%. Analysis of the clinical material showed that mediastinal infection was mostly associated with the following predisposing factors: (1) prolonged CPB time; (2) rethoracotomy; (3) open cardiac massage; (4) tracheostomy; (5) combined severe circulatory or/and respiratory complications. 28 patients were treated by mediastinal debridement and 27 of them were irrigated with 0.5% betadine or/and antibiotic solutions. Debridement was done a second time in 5 patients with smooth recovery. There were 15 deaths (48.4%), of which 4 were caused by rupture of cardiac or aortic incisions, 5 by multisystemic complications and 6 by severe infection. The mortality was significantly higher in the cases with combined circulatory or/and respiratory complications (72.2%) than in the cases of simple mediastinal infection (15.4%).
Shang
H
H
Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing.
D000293:Adolescent; D000328:Adult; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D003646:Debridement; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D007223:Infant; D008297:Male; D008480:Mediastinitis / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery