Delayed sternal closure: an effective procedure for life-saving in open-heart surgery

2010 ◽  
Vol 10 (2) ◽  
pp. 163-167 ◽  
Author(s):  
Haydar Yasa ◽  
Banu Bahriye Lafci ◽  
Levent Yilik ◽  
Mehmet Bademci ◽  
Aykut Sahin ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
Effective Procedure ◽  
Open Heart ◽  
Sternal Closure ◽  
Life Saving ◽  
Delayed Sternal Closure

scholarly journals Clinical Evaluation of Delayed Sternal Closure following Open Heart Surgery in Neonates and Infants.

1992 ◽  
Vol 21 (2) ◽  
pp. 149-154
Author(s):  
Masanao IMAI ◽  
Masahiro YAMAGUCHI ◽  
Hidetaka OHASHI ◽  
Yoshihiro OSHIMA ◽  
Naoki YOSHIMURA ◽  
...  
Keyword(s):  
Clinical Evaluation ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Sternal Closure ◽  
Delayed Sternal Closure ◽  
Neonates And Infants

scholarly journals Risk factors for delayed sternal closure after open-heart surgery in children under one year of age

2018 ◽  
Vol 10 (3-4) ◽  
pp. 288
Author(s):  
Stéphanie Delange ◽  
Jean-Benoît Thambo ◽  
Zakaria Jalal ◽  
Jean-Baptiste Mouton ◽  
Xavier Iriart ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Sternal Closure ◽  
Delayed Sternal Closure ◽  
One Year

A simple method of sternal traction to relieve compression of the heart after open heart surgery

1994 ◽  
Vol 4 (1) ◽  
pp. 82-83 ◽  
Author(s):  
Osamu Matsuki ◽  
Toshikatsu Yagihara ◽  
Yasunaru Kawashima
Keyword(s):  
Heart Surgery ◽  
Simple Technique ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Risk Of Infection ◽  
Simple Method ◽  
Sternal Closure ◽  
Delayed Sternal Closure

AbstractA simple technique is described with which to relieve postoperative compression of the heart. Although delayed sternal closure has conventionally been used to deal with postoperative compression, this maneuver always exposes the patient to the risk of infection. We have recently employed a simple method of sternal traction when there are signs of compression on temporary sternal closure. One or two couples of sutures in the sternum are used supported by bags of saline. This simple and effective method is applicable to patients, but especially to infants and neonates, without worrying about overindications.

Temporary pacing

ESC CardioMed ◽  
2018 ◽  
pp. 1978-1980
Author(s):  
Alexander Bauer
Keyword(s):  
Critical Care ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Non Invasive ◽  
Temporary Pacing ◽  
Life Saving ◽  
Transcutaneous Pacing ◽  
The Right

Temporary pacing was first introduced in 1952 by Zoll and co-workers. This life-saving technique is used in a variety of critical care settings. It can be achieved by leads placed in the right ventricle or atrium, or both, via the femoral, jugular, or subclavian vein. Epicardial insertion of pacing leads is frequently used during open heart surgery. A non-invasive option is transcutaneous pacing through adhesive electrode pads. This chapter discusses indications, technique, implantation, complications, and follow-up of temporary pacemakers.

Indications and Risks of Delayed Sternal Closure After Open Heart Surgery in Neonates and Early Infants

2012 ◽  
Vol 3 (2) ◽  
pp. 229-235 ◽  
Author(s):  
Ersin Erek ◽  
Yusuf Kenan Yalcinbas ◽  
Yasemin Turkekul ◽  
Arda Saygili ◽  
Ayse Ulukol ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Univariate Analysis ◽  
Open Heart Surgery ◽  
Morbidity Rate ◽  
Wound Complications ◽  
Skin Closure ◽  
Sternal Closure ◽  
Delayed Sternal Closure ◽  
Patch Closure ◽  
Mechanical Ventilation Time

Background: Delayed sternal closure (DSC) has been an essential part of neonatal and infant heart surgery. Here, we report our single institution experience of DSC for eight years. Methods: The successive 188 patients were analyzed retrospectively. Sternum was closed at the end of the operation in 97 (51.6%) patients (primary sternal closure [PSC] group). Sternum was left open in 91 (48.4%) patients. Among them, 45 (23.9%) had only skin closure (DSCs group) and 46 (24.4%) had membrane patch closure (DSC membrane [DSCm] group). Median age was higher in PSC group (90 days) than DSCs (11 days) and DSCm groups (9.5 days). Results: Mortality was 1%, 11.1%, and 28.2% in PSC, DSCs, and DSCm groups, respectively ( P < .05). Univariate analysis recognized the neonatal age (odds ratio [OR] = 4.2), preoperative critical condition (OR = 5.3), cardiopulmonary bypass time >180 minutes (OR = 4), and cross clamp time >99 minutes (OR = 3.9) as risk factors for mortality. Total morbidity rate was higher in DSCm group (73.9%) than DSCs group (51.1%) and PSC group (23.7%; P < .001). Mechanical ventilation time, intensive care unit stay, and hospital stay were longer in DSCs and DSCm groups than PSC group ( P < .001). The incidence of hospital infection was also higher in DSCs (43.5%) and DSCm (33.3%) groups than PSC group (20.6%; P < .05). But there was no difference in the incidence of sternal wound complications, including both deep and superficial (4.1%, 8.8%, and 4.4%, respectively). Conclusion: Although the risk of sternal wound complications is not different, patients who necessitate DSC (using both skin and membrane closure techniques) have more complicated postoperative course than patients with PSC.

The Hemostatic Mechanism after Open-Heart Surgery

1978 ◽  
Vol 39 (02) ◽  
pp. 474-487 ◽  
Author(s):  
E R Cole ◽  
F Bachmann ◽  
C A Curry ◽  
D Roby
Keyword(s):  
Extracorporeal Circulation ◽  
Heart Surgery ◽  
Polyacrylamide Gel Electrophoresis ◽  
Open Heart Surgery ◽  
Coagulation System ◽  
Open Heart ◽  
Time Activity ◽  
Post Surgery ◽  
Plasma Fractions ◽  
The Mean

SummaryA prospective study in 13 patients undergoing open-heart surgery with extracorporeal circulation revealed a marked decrease of the mean one-stage prothrombin time activity from 88% to 54% (p <0.005) but lesser decreases of factors I, II, V, VII and X. This apparent discrepancy was due to the appearance of an inhibitor of the extrinsic coagulation system, termed PEC (Protein after Extracorporeal Circulation). The mean plasma PEC level rose from 0.05 U/ml pre-surgery to 0.65 U/ml post-surgery (p <0.0005), and was accompanied by the appearance of additional proteins as evidenced by disc polyacrylamide gel electrophoresis of plasma fractions (p <0.0005). The observed increases of PEC, appearance of abnormal protein bands and concomitant increases of LDH and SGOT suggest that the release of an inhibitor of the coagulation system (similar or identical to PIVKA) may be due to hypoxic liver damage during extracorporeal circulation.

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