Related Experiment Videos
Risks of repeat sternotomy in pediatric cardiac operations
J L Russell1, J G LeBlanc, S S Sett
1Division of Cardiovascular and Thoracic Surgery, British Columbia's Children's Hospital, Vancouver, Canada.
The Annals of Thoracic Surgery
|January 6, 1999
Summary
Repeat sternotomy poses risks, but careful technique and femorofemoral bypass minimize complications. This study found similar survival rates and complication rates between repeat sternotomy and primary sternotomy patients.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Congenital Heart Disease Surgery
Background:
- Repeat sternotomy is often associated with increased perioperative risks.
- Previous studies have highlighted potential dangers in re-entering the chest.
Purpose of the Study:
- To evaluate the safety and outcomes of repeat sternotomy compared to primary sternotomy.
- To identify risk factors and protective measures for repeat sternotomy procedures.
Main Methods:
- A retrospective review of 165 patients undergoing 192 repeat sternotomies (group 1) versus 184 control patients (group 2).
- Analysis of various cardiac procedures including valve repair, septal defect closure, and Fontan procedures.
- Comparison of mortality, complication rates, blood loss, and length of stay.
Main Results:
- Hospital mortality was comparable: 2.6% in group 1 vs. 3.8% in group 2.
- Cardiac laceration occurred in 5.2% of repeat sternotomies, managed with femorofemoral bypass.
- Intensive care unit and hospital length of stay were longer in the repeat sternotomy group (p < 0.02 and p < 0.002).
- Overall survival at 120 months was high and not significantly different (97% vs. 95%).
Conclusions:
- Careful surgical technique and appropriate use of femorofemoral bypass can minimize the risks associated with repeat sternotomy.
- Repeat sternotomy is a safe procedure with acceptable outcomes when performed judiciously.