Surgical management of ascending aortic graft infection. No-sedation-technique for open mediastinal irrigation.

Two patients with ascending aortic graft infection were successfully treated. The first patient underwent ascending aortic replacement using a Dacron graft for aortic dissection, and developed graft infection. After 25 days' open mediastinal irrigation, allograft replacement and rectus muscle flap transfer were performed. The second patient underwent translocation of the aortic valve with a composite graft for calcific aortic stenosis, and developed graft infection. After 29 days' open irrigation, omental and rectus muscle flap transfer were performed. We were able to perform long-term open mediastinal irrigation using our original no-sedation-technique without any severe complication such as bleeding or secondary infection. We believe this technique is helpful in the management of severe ascending aortic graft infection.