Dysfunction of respiratory system after open heart surgery is one of the main problems in postoperative period. When mechanical ventilation is prolonged because of different causes, tracheostomy is usually performed, but the optimal time is still being discussed. In order to elucidate the influence of tracheostomy to subsequent course of disease we reviewed the indications, frequency and complications of postoperative tracheostomies performed in 1998-2000 in Cardiosurgical clinic after open heart surgery. The survey of our experience (only 15 tracheostomy procedures have been performed) showed that ventilation through tracheostomy tube is safe and comfortable way of application of prolonged mechanical ventilation: it is easier to stabilize, suction, and attach respiratory equipment. The patient can eat and, with some adjustments, can talk. Complications of tracheostomy are not often. If tracheostomy was well timed, the risk of trachea stenosis, infection of respiratory tract and other possible complications would decrease.