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Area of Science:

  • Cardiothoracic Surgery
  • Surgical Outcomes
  • Critical Care Medicine

Background:

  • Delayed sternal closure (DSC) is a strategy for complex cardiac surgeries.
  • Indications for DSC include bleeding and hemodynamic instability.
  • This study evaluates DSC outcomes over a 12-year period.

Purpose of the Study:

  • To investigate patients who underwent DSC.
  • To evaluate the postoperative results of DSC.
  • To compare DSC outcomes with primary sternal closure (PSC).

Main Methods:

  • Retrospective analysis of 124 DSC patients (1.8% of 6532) from January 2014 to September 2025.
  • Comparison of DSC patients with matched PSC patients.
  • Data collected included patient characteristics, morbidities, and mortality.

Main Results:

  • DSC patients had longer bypass and cross-clamp times, and higher CPB temperatures.
  • Increased need for inotropic support, IABP, ECLS, and blood transfusions in DSC group.
  • DSC associated with longer ICU/hospital stays and a 16.1% mortality rate; sternal infection rate was similar (2.4%).

Conclusions:

  • Multiple sternum revisions for bleeding/low cardiac output increase mortality in high-risk patients.
  • Planned DSC may reduce perioperative morbidity and mortality in select high-risk cardiac surgery patients.