Mediastinal infection is a feared complication observed after 0.4%-5% of ca
rdiac operations. Even today the mortality remains as high as 20%-40%. We d
iscuss the aetiology, mechanisms, prevention, diagnosis, and medical manage
ment. The staging system for mediastinal wound infections developed at a jo
int conference of German cardiac surgical centres is presented. The use of
parenteral polyvalent immunoglobulins is also discussed.