When Should the Sternum Be Closed After Aortic Surgery?

Authors : Veysel BAŞAR, Fatih YİĞİT, Fariz JAFAROV, Hasan SUNAR

Pages : 58-67

View : 18 | Download : 12

Publication Date : 2022-04-18

Article Type : Research Paper

Abstract :Introduction: There are many factors affecting postoperative morbidity and mortality in patients managed with delayed sternal closure insert ignore into journalissuearticles values(DSC); after aortic surgery. This study aimed to examine the postoperative management of patients after DSC and the factors affecting morbidity and mortality. Patients and Methods: Among 2151 patients who underwent ascending aorta and/or aortic valve surgery between January 2012 and December 2020, 64 patients managed with DSC were included in the study. The records of the patients were obtained from the hospital archive/hospital electronic database. Postoperative day 30 was determined as early mortality. Results: Uncontrollable bleeding 34.4% insert ignore into journalissuearticles values(n= 22);, LCOS insert ignore into journalissuearticles values(Low Cardiac Output Syndrome); 31.4% insert ignore into journalissuearticles values(n= 20); and mediastinal edema 28.1% insert ignore into journalissuearticles values(n= 18);were the main causes for DSC. In the remaining patients insert ignore into journalissuearticles values(6.3%, n= 4);, DSC was preferred for other non-specific reasons such as uncontrollable arrhythmia. Forty-five patients’ chests insert ignore into journalissuearticles values(70.3%); were closed in the postoperative period, and 19 patients insert ignore into journalissuearticles values(29.7%); could not be closed due to death insert ignore into journalissuearticles values(p 0.05);. However, the closure time was longer in patients with a previous operation history, postoperative acute renal failure, surgical site infection, and postoperative bleeding revision/surgical revision insert ignore into journalissuearticles values(p< 0.05);. Conclusion: DSC can be preferred as a life-saving method for various reasons such as bleeding diathesis, mediastinal edema, and malignant arrhythmia after open-heart surgery. Accurate timing and close follow-up are important for sternal closure. In these patients, a multidisciplinary approach is required in the postoperative period.
Keywords : Thoracic surgery, postoperative wound infection, mediastinitis, ascending aorta