Outcomes of delayed sternal closure after complex aortic surgery☆
| Autor: | Riad Meada, Hazim J. Safi, Paul Achouh, Adel D. Irani, Eyal E. Porat, Charles C. Miller, Anthony L. Estrera |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Sternum medicine.medical_specialty Blood transfusion medicine.medical_treatment law.invention Blood Vessel Prosthesis Implantation law Edema medicine.artery Cardiopulmonary bypass medicine Humans Surgical Wound Infection Hospital Mortality Postoperative Period Respiratory system Aorta Aged Aged 80 and over Postoperative Care Cardiopulmonary Bypass business.industry General Medicine Length of Stay Middle Aged medicine.disease Mediastinitis Surgery Treatment Outcome Circulatory system Female medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 33:1039-1042 |
| ISSN: | 1010-7940 |
| DOI: | 10.1016/j.ejcts.2008.02.025 |
| Popis: | Objective: Open chest management during complex proximal aortic surgery may sometimes be necessary. Infectious complications such as mediastinitis and late aortic graft infection remain a concern. The objective of this study was to report our experience with open chest management and delayed sternal closure after complex proximal aortic surgery. Methods: Between 1991 and 2007, 12 patients (1.2%, 12/1011) required open chest management and delayed sternal closure. Eight patients were men (67%), with a mean age of 56 years (range 28-83 years). Four cases involved redo-median sternotomy (33%) and seven cases (58%) involved acute dissection. All procedures were performed using total cardiopulmonary bypass with profound hypothermic circulatory arrest. Reasons for open chest management included hemodynamic instability, mediastinal edema, bleeding, and respiratory compromise. Results: In-hospital mortality was 16.7% (2/12). Delayed sternal closure was achieved in 92% of patients (11/12). Mean time to closure was 3 days (range 1-9 days). Five patients (42%) required one or more mediastinal explorations prior to final closure. Mean length of stay was 51 days (range 1-186 days). Significant predictors of open chest management were pump time (p |
| Databáze: | OpenAIRE |
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