OBJECTIVES: To identify risk factors in 60 cases of @entity1764 amongst 2512 @entity1 (2.3%) subjected to isolated coronary bypass surgery from March 1988 through December 1995, treated by a closed irrigation/drainage system. @entity1 AND METHODS: The mean age of the 60 @entity1 was 56.9 +/- 6.8 years (45-81 years) and 55 (91.6%) were male. Early mediastinal reexploration was performed in all cases immediately after the diagnosis of @entity1764 , with debridement of necrosed tissues, followed by implantation of a closed-circuit irrigation system of the mediastinum constituted by irrigation catheter and drain, closure of the sternum and skin, and specific systemic antibiotic therapy. The mean interval between the original surgery and reexploration was 9.4 days (range 6-14 days). No @entity1 required more extensive procedures, @entity3986 . Twenty potential risk factors in @entity1 with @entity1764 , including @entity6 , @entity28 , coexistence of @entity1095 , decreased LV function, use of inotropes, mediastinal blood drainage and utilization of double IMA, were compared with the group without @entity1764 . RESULTS: Mean cardiopulmonary bypass time was 74.1 +/- 8.1 min, anesthetic time 3.5 +/- 0.8 h and postoperative mechanical ventilation 18 +/- 3 h. A total of 23 @entity1 (38.3%) received one IMA and 35 (58.3%) two IMAs. In the postoperative period, 7 of the 60 @entity1 (11.6%) had required inotropes because of low output. Mediastinal @entity190 was 1112cc +/- 452cc and 9 @entity1 (15%) were transfused. Cultures were positive in 40 cases (66.6%) and the most frequent infecting agent was the Staph. epidermidis in 25 cases (62.5%), followed by @entity5132 and Enterobacter and Serratia species (7.5% each); 1 @entity1 (1.7%) died and 9 (15%) had @entity177 . The irrigation/drainage was maintained for a mean of 9.1 days (5-83 days). @entity1 with @entity1764 had a significantly higher prevalence of @entity6 (41.6% vs. 18.8%; P < 0.01), @entity28 (48.3% vs. 15.2%; P < 0.001), @entity1095 (11.6% vs. 4.0%; P < 0.05), but a lower incidence of poor LV function (18.3% vs. 32.7%; P < 0.05). A double IMA was used more frequently in @entity1 who had @entity1764 (58.3% vs. 23.5%; P < 0.001) CONCLUSIONS: @entity6 , @entity28 , co-existence of @entity1095 and use of double IMA are risk factors for @entity1764 after coronary artery surgery. The efficacy of the closed method of treatment with a mediastinal irrigation/drainage system was increased with early diagnosis and reintervention.

XXXX after aorto-coronary bypass surgery.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'PATIENTS'] @entity1095 :: ('MESH:D016491', 'Disease') :: ['peripheral vascular disease'] @entity28 :: ('MESH:D009765', 'Disease') :: ['obesity'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes', 'diabetes mellitus', 'Diabetes mellitus'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity3986 :: ('MESH:D009136', 'Disease') :: ['namely omental or muscular flaps'] @entity1764 :: ('MESH:D008480', 'Disease') :: ['mediastinitis'] @entity5132 :: ('5476', 'Species') :: ['Candida albicans'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal failure']
@entity1764 :: (MESH:D008480,Disease) :: ['Mediastinitis']
