Does mediastinitis affect the graft patency?
As inflammation began to be recognized as a major contributor to the pathogenesis of atherosclerosis, we evaluated the patients that developed mediastinitis, a long-standing inflammatory process, after coronary artery bypass grafting. There are many studies that have focused on the graft patency. But, till now, no study has been done to detect the effects of mediastinitis to graft patency. So, we aimed to detect the effect of mediastinitis on the graft patency in patients who have undergone coronary artery bypass surgery. Sixteen of 45 patients who have been operated upon for coronary artery bypass surgery and developed mediastinitis, which was treated with open drainage and mediastinal irrigation with late wound closure, were included in the study. The mean age of the patients was 55 +/- 11 (range 35-69) and nine of the patients were male. The graft patency was evaluated with control coronary angiographies after a mean period of 30.42 +/- 43.17 months (range 1-132). The left internal thoracic artery was patent in all patients (100%). Right internal thoracic artery patency rate was 50% (1/2). One individual bypassed radial artery was patent, whereas the sequential bypassed graft was occluded. The patency ratio of radial artery anastomosis was 33% (1/3). Twelve of the 17 saphenous vein grafts were patent (70.58%). The total number of patent distal anastomosis was 30/38 (78.94%). When compared with the graft patency of patients without infection, it was found that mediastinitis does not affect the graft patency rates adversely.
Mansuroğlu
Denyan
D
Kouyolu Heart and Research Hospital, Department of Cardiovascular Surgery, Istanbul, Turkey. dmansuroglu@kosuyolu.gov.tr
Omeroğlu
Suat Nail
SN
Kaya
Erhan
E
Kirali
Kaan
K
Sişmanoğlu
Mesut
M
Mataraci
Ilker
I
Güler
Mustafa
M
Ipek
Gökhan
G
Yakut
Cevat
C
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D004322:Drainage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000453:epidemiology* / Q000209:etiology; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D008297:Male; D008480:Mediastinitis / Q000209:etiology* / Q000382:microbiology / Q000628:therapy; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D011184:Postoperative Period; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D014654:Vascular Patency / Q000502:physiology*