Wound infections are caused when bacterial sources in the hospital affect the patient. These are becoming less common with preventive efforts and improved surgical procedures, but infection in the blood and infections in or around the heart can be very serious complications. Infection is a particular risk when prosthetic valves are used and when catheters and pacemakers are implanted. Infections can arise within these devices and get into the body once the devices are inserted.

Abscess formation can occur in static postoperative fluids in and around the heart and along incision sites. Percutaneous drainage may be required in such circumstances (Fig. 23.2).

All patients have some degree of bleeding after cardiac surgery. Surgical drains are placed and drain the expected hemorrhage, but rarely, bleeding can be excessive and will require intervention to stop active extravasation or hemorrhage.

A contained hemorrhage or pseudoaneurysm occurs when hemorrhage is contained by perivascular structures. Pseudoaneurysms can occur anywhere along the vascular system but especially at anastomosis sites. A pseudoaneurysm must maintain active communication with the arterial system. Options for treating a pseudoaneurysm include graded ultrasound compression, covered stent placement, thrombin injection, and surgical ligation (Fig. 23.3).