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[Open heart surgery in patients with a tracheostoma]
1Department of Cardiothoracic Surgery, University of Tokyo, Japan.
Summary
Open heart surgery is safe for patients with a tracheostoma. Surgical techniques like full or partial sternotomy can be safely performed, even enabling left internal thoracic artery (LITA) harvesting.
Area of Science:
- Cardiothoracic Surgery
- Anesthesiology
Context:
- Patients requiring open heart surgery may have a tracheostoma, posing surgical challenges.
- Previous literature lacks comprehensive data on managing these specific patient cases.
Purpose:
- To evaluate the safety and feasibility of different sternotomy techniques in patients with a tracheostoma undergoing open heart surgery.
- To assess the applicability of left internal thoracic artery (LITA) harvesting in this patient cohort.
Summary:
- Six patients with tracheostomas underwent open heart surgery between April 1992 and May 1997.
- Surgical approaches included full median sternotomy, partial median sternotomy, and right anterolateral thoracotomy.
- No operative deaths or infections occurred. LITA grafting was successfully performed in two partial sternotomy cases, with graft procurement facilitated by pre-sternotomy dissection.
Impact:
- Demonstrates the safety of full and partial sternotomies in tracheostoma patients.
- Highlights the feasibility of LITA harvesting during partial sternotomy, expanding reconstructive options.
- Provides evidence for successful surgical management in a challenging patient population.