Advantages of delayed sternal closure in cardiac-compromised adult patients

F. Donatelli, M. Triggiani, S. Benussi, A. Grossi

Research output: Contribution to journalArticlepeer-review

Abstract

Severe hemodynamic dysfunction may follow closure of the median sternotomy in patients with myocardial edema, cardiac dilatation, postcardiotomy shock, or raised end-expiratory alveolar pressure. Open sternotomy and delayed sternal closure (DSC) is a well described adjunct in complicated cardiac operations, which is more widely applied in neonates. In this article we report our results in using open sternotomy in eight adult patients from January 1994 to February 1995 (excluding patients who needed ventricular assistance devices [VADs]). Three patients died in hospital: 1 case of multiorgan failure; 1 case of refractory low cardiac output syndrome; and 1 case of respiratory distress syndrome. Our experience confirms that DSC is an effective means of dealing with postoperative hemodynamic impairment. Furthermore, this technique may represent an intermediate step between intraaortic balloon counterpulsation and VADs and should be given a role in the prophylaxis of low postoperative cardiac output and multiorgan failure, particularly when contraindications to VAD exist.

Original languageEnglish
Pages (from-to)632-636
Number of pages5
JournalJournal of Cardiac Surgery
Volume10
Issue number6
Publication statusPublished - 1995

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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