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Deep sternal wound infection after bilateral internal thoracic artery grafting: Insights from a Japanese national

Suguru Ohira1, Hiroaki Miyata2, Sachiko Yamazaki1

  • 1Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.

The Journal of Thoracic and Cardiovascular Surgery
|October 13, 2018
PubMed

Insights

Bilateral internal thoracic artery (BITA) grafting shows satisfactory early outcomes, with a 1.6% incidence of deep sternal wound infection (DSWI). Identifying risk factors helps predict DSWI in BITA grafting patients.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Medical Databases

Background:

  • Bilateral internal thoracic artery (BITA) grafting offers survival benefits but is underutilized due to deep sternal wound infection (DSWI) concerns.
  • Japanese national database (Japan Adult Cardiovascular Surgery Database) used to assess BITA grafting outcomes.
  • DSWI defined as wound infection requiring surgical intervention or antibiotics.

Purpose of the Study:

  • Investigate early outcomes of BITA grafting.
  • Analyze risk factors for DSWI following BITA grafting.

Main Methods:

  • Utilized data from 560 hospitals (April 2012-December 2015).
  • Included 14,249 patients undergoing BITA grafting (32.6% of isolated CABG).
  • Employed multiple logistic regression to identify DSWI risk factors.

Main Results:

  • Overall DSWI incidence was 1.6% (234 patients); operative mortality was 1.6% (226 patients).
  • Mortality in DSWI patients was 13.7% (32 patients).
  • Identified independent risk factors for DSWI: female sex, diabetes, chronic lung disease, renal failure, liver dysfunction, low ejection fraction, shock, reoperation, IABP use, and longer operative time. Off-pump technique did not reduce DSWI risk.

Conclusions:

  • Early outcomes of BITA grafting are satisfactory concerning DSWI and operative mortality.
  • Data provide valuable insights for predicting DSWI risk in BITA grafting procedures.
Abstract

Keywords:
bilateral internal thoracic arterycoronary artery bypass graftingdeep sternal wound infection

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