Effect of Repeat Sternotomy on Cardiac Surgery Outcomes
Anthony Lemaire, George Batsides, Aziz Ghaly, Takashi Nishimura, Leonard Y. Lee. Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ USA.
Objective: To determine the impact of repeat sternotomy after adult cardiac surgery on surgical outcomes. The primary endpoints include operative mortality and rate of reoperation for bleeding.
Methods: A retrospective review of prospectively collected data from a single institution. The patients underwent coronary artery bypass grafting (CABG), valvular surgery (VS), CABG and VS and other procedures from July 1, 2011 to December 31, 2013. Charts were evaluated for demographics, operative details and postoperative outcomes. Operative mortality was defined as death within 30-days of surgery.
Results: The average age of the patients was 67.13 ±14 and the majority of the patients were male (N=118). We identified 165 patients who underwent adult cardiac surgery. Of the patients, 54 patients had an aortic valve replacement (AVR), 34 patients had a mitral valve procedure, 14 patients had multiple valvular procedures, 24 patients had CABG, 10 patients had CABG and VS, and 29 patients had additional procedures including aortic dissection repair. The mortality rate was 6.06% for the entire group with 3% mortality for AVR, and 0% for CABG. The rate of reoperation for bleeding is 2.4% for the entire group with 1.9% for AVR, and 0% for CABG.
Conclusions: Repeat sternotomy has increased risk for patients undergoing adult cardiac surgery. The data from our study shows that the patients who underwent redo-sternotomy had low mortality and the rate of reoperation is low at 2.4% for postoperative bleeding. Although the risks are enhanced with the proper preparation patients can have successful outcomes.