Literature DB >> 20563463

Postoperative mediastinitis in cardiovascular surgery postoperation. Analysis of 1038 consecutive surgeries.

Michel Pompeu Barros de Oliveira Sá1, Débora Oliveira Silva, Erika Nibbering de Souza Lima, Ricardo de Carvalho Lima, Frederico Pires Vasconcelos Silva, Fábio Gonçalves de Rueda, Rodrigo Renda de Escobar, Paulo Ernando Ferraz Cavalcanti.   

Abstract

OBJECTIVE: To report the incidence of mediastinitis in cardiovascular surgery postoperation.
METHODS: The records of all 1038 patients who underwent cardiovascular surgical procedures between May/2007 and June/2009 were reviewed. All operations were performed in Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco - PROCAPE.
RESULTS: The complication occurred within, on average, 13 days after operation, in total of 25 (2.4%), eight (32%) deaths occurred. Several risk factors mediastinitis were identified: 56% diabetes, 56% smokers, 20% obeses, 16% with chronic obstructive pulmonary disease and 8% of chronic renal failure. Mediastinitis were reported in 21 (84%) cases of patients submitted to coronary artery bypass grafting, being associated to major risk of infection development (IC 3.448.30, P=0.0001). High rates of complications were observed: respiratory insufficiency (44%), stroke (16%), cardiogenic shock (12%), acute renal failure (28%), pulmonary infection (36%), multiple organs failure (16%) and esternal deiscence (48%). Bacterial cultures of exudates were positive in 84% of patients; Staphylococcus aureus was the most responsible pathogen (28.8%).
CONCLUSION: Mediastinitis stays a serious surgical complication and difficult management in cardiovascular surgery postoperation. The disease stays with low incidence, but still with high lethality. Coronary bypass was associated to major risk of infection development.

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Year:  2010        PMID: 20563463

Source DB:  PubMed          Journal:  Rev Bras Cir Cardiovasc


  6 in total

Review 1.  Skeletonized versus pedicled internal thoracic artery and risk of sternal wound infection after coronary bypass surgery: meta-analysis and meta-regression of 4817 patients.

Authors:  Michel Pompeu Barros de Oliveira Sá; Paulo Ernando Ferraz; Rodrigo Renda Escobar; Frederico Pires Vasconcelos; Alvaro Antonio Bandeira Ferraz; Domingo Marcolino Braile; Ricardo Carvalho Lima
Journal:  Interact Cardiovasc Thorac Surg       Date:  2013-02-27

2.  Adjunctive Hyperbaric Oxygen Therapy or Alone Antibiotherapy? Methicillin Resistant Staphylococcus aureus Mediastinitis in a Rat Model.

Authors:  Tolga Kurt; Ahmet Vural; Ahmet Temiz; Ersan Ozbudak; Ali Umit Yener; Suzan Sacar; Mustafa Sacar
Journal:  Braz J Cardiovasc Surg       Date:  2015 Sep-Oct

3.  Cefazolin Concentration in the Mediastinal Adipose Tissue of Patients Undergoing Cardiac Surgery.

Authors:  Rodrigo Mezzalira Tchaick; Michel Pompeu Barros Oliveira Sá; Fernando Ribeiro de Moraes Figueira; Kilma Coelho Paz; Álvaro Antonio Bandeira Ferraz; Fernando Ribeiro de Moraes
Journal:  Braz J Cardiovasc Surg       Date:  2017 Jul-Aug

Review 4.  Sternal wound tuberculosis following cardiac operations: a review.

Authors:  Shi-Min Yuan
Journal:  Rev Bras Cir Cardiovasc       Date:  2015 Jul-Aug

5.  Predictors of Mediastinitis Risk after Coronary Artery Bypass Surgery: Applicability of Score in 1.322 Cases.

Authors:  Fabiana Dos Santos Oliveira; Letícia Delfino Oliveira de Freitas; Eneida Rejane Rabelo-Silva; Laura Maggi da Costa; Renato Abdala Karam Kalil; Maria Antonieta Pereira de Moraes
Journal:  Arq Bras Cardiol       Date:  2017-08-17       Impact factor: 2.000

6.  Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence.

Authors:  Grazielle de Souza Horácio; Pedro Soler Coltro; Antonio Albacete; Juliano Baron Almeida; Vinícius Zolezi da Silva; Ivan de Rezende Almeida; Alfredo José Rodrigues; Jayme Adriano Farina
Journal:  Braz J Cardiovasc Surg       Date:  2017 Sep-Oct
  6 in total

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