HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Richard Firmin Mark Hickey Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Elahi, M. Articles by Hickey, M. Search for Related Content PubMed PubMed Citation Articles by Elahi, M. Articles by Hickey, M. Related Collections Mediastinum

Direct Complications of Repeat Median Sternotomy in Adults

Department of Cardiothoracic Surgery, Glenfield Hospital, Leicester, United Kingdom

For reprint information contact: Maqsood M Elahi, MRCS Tel: 44 116 250 2687 Fax: 44 792 901 0164 Email: manzoor_elahi{at}hotmail.com, Department of Cardiac Surgery, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, United Kingdom.

Whilst the potential risk to underlying vital structures from redo-sternotomy is well recognized, the actual risk is poorly quantified. Our aim was to determine the incidence of complications directly attributable to redo-sternotomy and to ascertain whether the use of femoro-femoral CPB (FF) prior to redo-sternotomy alters operative morbidity and mortality. Case notes of 185 patients undergoing cardiac surgery necessitating redo-sternotomy between May 1998 and November 2002 were reviewed. Of 121 males and 64 females, the median age was 65.5 years (range 60.1–75 years). Elective FF was performed in 71 (38.3%) of cases and 114 (60%) were performed without the aid of prior femoro-femoral CPB (WFF). Three (1.6%) patients initially planned for WFF were converted to emergency FF due to serious complications. Complications directly attributable to redo-sternotomy occurred in 21 (11.3%) cases; 12 (16.9%) in the FF group and 9 (5.3%) in the WFF group. Overall mortality was 1.6%. In summary, our results suggest that morbidity risk for the operation increases significantly with redo-sternotomy alone. Three deaths in our series from direct complications attributable to redo-sternotomy signify an added risk. Hence the necessity for careful surgical technique and judicious use of elective FF-CPB is emphasized.

This article has been cited by other articles:

				D. L.S. Morales, F. Zafar, K. A. Arrington, S. M. Gonzalez, E. D. McKenzie, J. S. Heinle, and C. D. Fraser Jr Repeat Sternotomy in Congenital Heart Surgery: No Longer a Risk Factor Ann. Thorac. Surg., September 1, 2008; 86(3): 897 - 902. [Abstract] [Full Text] [PDF]

				N. Muthialu Direct complications of sternal re-entry. Asian Cardiovasc Thorac Ann, February 1, 2006; 14(1): 90 - 90. [Full Text] [PDF]