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Published on: March 26, 2018
Cardiac injury during resternotomy does not affect perioperative mortality
Peter I Ellman1, Robert L Smith, Micah E Girotti
1Department of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville, VA, USA.
Journal of the American College of Surgeons
|May 13, 2008
Summary
Cardiac injury during resternotomy does not increase patient mortality. However, undergoing a third resternotomy is a significant risk factor for such injuries, necessitating increased surgical vigilance.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Surgical Complications
Background:
- Cardiac injury during resternotomy is a known complication.
- Limited data exists on the impact of cardiac injury during resternotomy on patient outcomes.
- This study aimed to investigate the effects of cardiac injury during resternotomy on morbidity and mortality.
Purpose of the Study:
- To determine the incidence of cardiac injury during resternotomy.
- To assess the association between cardiac injury during resternotomy and perioperative morbidity and mortality.
- To identify risk factors for cardiac injury during resternotomy.
Main Methods:
- Retrospective review of 612 resternotomies performed between 1996 and 2005.
- Analysis of operative notes for cardiac, great vessel, or bypass graft injuries.
- Perioperative complications and mortality data collected from the Society of Thoracic Surgeons National Database.
Main Results:
- Cardiac injury occurred in 9.1% of resternotomies.
- Graft injury was most common (46.4%), followed by right ventricle injury (21.4%).
- No significant difference in mortality was observed between injured and non-injured groups. Third-time resternotomy was an independent risk factor for injury.
Conclusions:
- Cardiac injury during resternotomy is not associated with increased perioperative morbidity or mortality.
- Third-time resternotomy is an independent risk factor for cardiac injury.
- Vigilance and preparation are crucial for patients undergoing repeat resternotomies.
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