A mediastinitis after a graft replacement of the ascending aorta is serious complication and sometimes could be lethal. We have experienced two cases of such a condition, recently. In both cases, the debridement of the mediastinum and omental transposition were performed. Case 1 had a recurrent mediastinitis due to residual dead space infection, but was cured by a percutaneous drainage and a continuous irrigation. In case 2, the omentum was carefully positioned to occupy the dead space around the graft, because of the experience of the first case and gave a good result. We believe that omental transposition is an effective treatment for the postoperative mediastinitis.

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