Abstract
The article is dedicated to the review of world literature regarding the complications associated
with resternotomy and cardiolysis and possible methods of X-ray diagnostics of adhesive process
in mediastinum in case of planning the cardiac reoperation. Postoperative adhesions in cardiac
surgery are associated with the increased risk of iatrogenic lesion of great vessels and heart
structures in reoperations. Ethiology and pathogenesis of adhesion formation are studied
insufficiently and there are no reliable agents and methods for prophylaxis and treatment
of adhesions, thus instrumental methods of study are the uppermost in planning the repeated
cardiac surgeries. X-ray study, echocardiography and angiography offer the possibility to suspect
the presence of adhesive process in mediastinum only according to the indirect indicators and
dont give the comprehensive information. It was reported that computed tomography had been
used preoperatively, and using this method, surgeons could consider the retrosternal, mediastinal
and cardiac anatomy in order to determine the current complications better and to help in
preoperative analysis and choose the strategy of catheterization. Chest computed tomography
during the reoperation provides an ability to assess the position of mediastinal organs in details
and facilitates the secondary opening of the sternum. Magnetic resonance imaging is one of the
most important powerful instruments of visualization of mediastinal topography, postoperative
pericardial changes and mediastinal adhesions, but it is sensitive to metal inclusions which often
remain after primary surgical interventions.
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