[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%).