EVALUATION OF OPEN CHEST MANAGEMENT (OCM) WITH DELAYED STERNAL CLOSURE (DSC) AFTER CARDIAC SURGERY

Authors

  • Seyyed Hossein Ahmadi Tafti
  • Abbas Ali Karimi
  • Armita Mahdavi Gorabi
  • Farhad Fathi
  • Mohammad Reza Rezaei
  • Saeid Davoudi
  • Khosro Barkhordari

DOI:

https://doi.org/10.47144/phj.v50i4.1363

Abstract

Objective: In this study, we evaluated the open chest management (OCM) withdelayed sternal closure (DSC) after cardiac surgery.

Methodology: A total of 22721 patients who underwent open heart operation wereincluded in the study. Delayed sternal closure was performed in 362 (1.5%)patients with mean age of 59.01 ± 12.4 years. Males were 63% (n=229).Therate of DSC was 1.5% and was performed because of the hemodynamicinstability, bleeding, arrhythmia, tamponade and aortic dissection. The mortalityrate was 28.5%. Diabetes and emergency status of the operation were twopredictors of mortality (p<0.001). Moreover, analysis pointed out that diabetes;severe chronic lung disease and postoperative need for hemodialysis were thestrongest independent predictors of mortality in patients under going opensurgery with DSC. The most prevalent post operation, complications were atrialfibrillation, bleeding, pulmonary embolism and new onset renal failure withincidence rates of 38.4% (139), 26.2% (95), 15.2% (55), and 9.1% (33)respectivelyT

Result: A total of 22721 patients who underwent open heart operation wereincluded in the study. Delayed sternal closure was performed in 362 (1.5%)patients with mean age of 59.01 ± 12.4 years. Males were 63% (n=229).Therate of DSC was 1.5% and was performed because of the hemodynamicinstability, bleeding, arrhythmia, tamponade and aortic dissection. The mortalityrate was 28.5%. Diabetes and emergency status of the operation were twopredictors of mortality (p<0.001). Moreover, analysis pointed out that diabetes;severe chronic lung disease and postoperative need for hemodialysis were thestrongest independent predictors of mortality in patients under going opensurgery with DSC. The most prevalent post operation, complications were atrialfibrillation, bleeding, pulmonary embolism and new onset renal failure withincidence rates of 38.4% (139), 26.2% (95), 15.2% (55), and 9.1% (33)respectively.

Conclusion: The hemodynamic instability, bleeding, arrhythmia, tamponade andaortic dissection were the most important factors for the performance of DSCwhile diabetes and emergency status of the operation were the most importantpredictors of mortality.

Key Words: Open chest management , Delayed sternal closure , Cardiac surgery,Open sternum.

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How to Cite

1.
Ahmadi Tafti SH, Karimi AA, Gorabi AM, Fathi F, Rezaei MR, Davoudi S, Barkhordari K. EVALUATION OF OPEN CHEST MANAGEMENT (OCM) WITH DELAYED STERNAL CLOSURE (DSC) AFTER CARDIAC SURGERY. Pak Heart J [Internet]. 2018Mar.20 [cited 2024Nov.24];50(4). Available from: https://pakheartjournal1.pcs.org.pk/index.php/pk/article/view/1363

Issue

Vol. 50 No. 4 (2017): Pakistan Heart Journal

Section

Original Article

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