title: Profuse mediastinal haemorrhage due to mediastinitis after sternotomy. Report of three cases and review of the literature.
abstract: Profuse spontaneous haemorrhage occurred in association with mediastinitis after median sternotomy for coronary bypass surgery in three men aged 54, 47 and 59 years. The bleeding sites were aorta, right ventricle and saphenous bypass graft. The aortic rupture occurred during closed lavage, the right ventricle ruptured during open saline mediastinal packing and the saphenous vein graft was eroded by a mediastinal drainage tube after discontinuation of closed lavage. This third patient survived and recovered, but the two others died. Previously published reports of 56 patients with 65 bleedings from this rare complication are reviewed. The outcome was fatal in 34% of cases.
authors.affiliation: Department of Medicine, Helsinki University Central Hospital.
authors.forename: J
authors.initials: J
authors.lastname: Partanen
authors.forename: K A
authors.initials: KA
authors.lastname: Verkkala
authors.forename: P J
authors.initials: PJ
authors.lastname: Karhunen
authors.forename: R
authors.initials: R
authors.lastname: Kauppila
authors.forename: M S
authors.initials: MS
authors.lastname: Nieminen
mesh_terms: D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000209:etiology*; D008480:Mediastinitis / Q000150:complications* / Q000209:etiology*; D008875:Middle Aged; D011183:Postoperative Complications; D013249:Sternum / Q000601:surgery*