Abstract
A 73-year-old man diagnosed as having unstable angina underwent A-C bypass procedure employing the internal thoracic artery (ITA), gastroepiploic artery and saphenous vein. Six days later, complication of mediastinitis due to MRSA developed and was treated with irrigation using antibiotic and povidone-iodine solution. On the 13th postoperative day massive hemorrhage suddenly occurred from the pericardial drainage tube, and emergency operation was carried out. During surgery rupture of the ITA was revealed. After ligation of the ITA, the infected sternum and costal cartilages were removed and bilateral pectoralis major muscles were transposed on the anterior mediastinum. The mediastinal infection was well controlled without dysfunction of the pectoralis major muscles by the 49th postoperative day. It was considered that the transposition of the pectoralis major muscles was effective for mediastinitis after A-C bypass procedure in this patient.
