Department of Cardiovascular Surgery, Dışkapı Education and Research Hospital, Ankara, Turkey.
Department of Cardiovascular Surgery, Ankara City Hospital, Ankara, Turkey.
J Coll Physicians Surg Pak. 2021 Sep;31(9):1069-1074. doi: 10.29271/jcpsp.2021.09.1069.
To determine the efficacy of a sternal wire system in secondary sternal dehiscence after repeat closure of the sternum, following surgical revision after open heart surgery.
Case-control study.
Department of Cardiovascular Surgery, Zonguldak Bülent Ecevit University, Zonguldak, Turkey; and Turkey Yuksek Ihtisas Training and Research Hospital, Turkey, from January 2015 to May 2019.
Patients, who underwent open heart surgery with median sternotomy, were included in this retrospective study. The patients were divided into two groups, according to the sternal closure material. The time of the sternal reconstruction surgery, because of sternal dehiscence, fracture, broken sternal wire(s) or cable(s) after the first revision surgery, was noted for each patient.
A total of 389 patients were identified. Group 1 included 72 (50%) patients whose sternums were closed with a sternal cable system; and Group 2 included 72 (50%) patients whose sternums were closed with conventional steel wires after propensity matching. The duration of cardiopulmonary bypass, number of intra-aortic balloon pumps used, and number of extracorporeal membrane oxygenators used were significantly higher in Group 1 (p = 0.007, p = 0.034, and p = 0.028, respectively). The number of emergency operations was significantly higher in Group 2 (p = 0.021). There was no significant difference in terms of secondary sternal dehiscence between the groups (p = 0.366).
Application of the sternal wire system in revisional open heart surgery is not more effective than conventional steel wire at preventing secondary sternal dehiscence. Key Words: Sternal dehiscence, Sternal cable, Sternal wire, Open heart surgery, Postoperative revision.
确定胸骨钢丝系统在心脏直视手术后胸骨切开术修复后再次发生胸骨裂开时的疗效。
病例对照研究。
土耳其宗古尔达克比伦特·埃切维特大学心胸外科和土耳其 Yuksek Ihtisas 培训和研究医院，2015 年 1 月至 2019 年 5 月。
回顾性研究纳入接受正中胸骨切开术的心脏直视手术患者。根据胸骨闭合材料将患者分为两组。每位患者的胸骨重建手术时间均因第一次修正手术后胸骨裂开、骨折、胸骨钢丝或钢缆断裂而记录。
共确定了 389 名患者。第 1 组包括 72 名（50%）胸骨采用胸骨缆线系统闭合的患者；第 2 组包括 72 名（50%）胸骨采用传统钢丝闭合的患者。第 1 组的体外循环时间、主动脉内球囊泵使用数量和体外膜氧合器使用数量显著更高（p = 0.007、p = 0.034 和 p = 0.028）。第 2 组急诊手术的数量显著更高（p = 0.021）。两组间二次胸骨裂开无显著差异（p = 0.366）。
在心脏直视手术的修正手术中，胸骨钢丝系统的应用并不能比传统钢丝更有效地预防二次胸骨裂开。
胸骨裂开、胸骨缆线、胸骨钢丝、心脏直视手术、术后修正。
