| Does technical failure of revascularization during coronary artery bypass grafting predict severity of poststernotomy mediastinitis? | |
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MedLine Citation:
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PMID: 15544078 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND AIMS: To assess the impact of unsuccessful revascularization in relation to poststernotomy mediastinitis (PSM), which affects long-term outcome after coronary artery bypass grafting (CABG). MATERIAL AND METHODS: An active approach for the follow-up of PSM involved a step by step treatment protocol of conventional surgery and plastic reconstructive surgery. 47 patients treated for PSM after CABG were identified and further evaluated. Complete revascularization was considered unsuccessful when technical hazards were reported during CABG. When PSM subsided after thorough debridement and sternal refixation without plastic reconstructive surgery, such as omentoplasty or muscle transposition, PSM was categorized as mild PSM. If treatment required plastic reconstructive surgery, PSM was categorized as severe PSM. Preoperative coronary artery angiographic status and success of revascularization were compared to postoperative outcome in relation to mild and severe PSM. RESULTS: 36 patients suffered from mild PSM and 11 patients from severe PSM. Preoperative clinical status did not differ among patients. Two patients (4.3 %) died during hospitalization. The need for plastic reconstructive surgery was significant (p < 0.05) among patients with unsuccessful revascularization. 35 out of 41 patients (85 %) without problems of graft anastomosis during CABG (successful revascularization) were associated with mild PSM, whereas only 6 out of 41 patients (15 %) with successful revascularization during CABG required plastic reconstructive surgery (p < 0.05). Technical failure of graft anastomosis (3 cases) or poor outflow of internal thoracic artery (2 cases) were statistically associated with severe PSM. CONCLUSION: Technical failures of revascularization during CABG may delay recovery from PSM. |
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Authors:
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A Mennander; P Maaranen; B Negre; M Tarkka |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society Volume: 93 ISSN: 1457-4969 ISO Abbreviation: Scand J Surg Publication Date: 2004 |
Date Detail:
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Created Date: 2004-11-16 Completed Date: 2004-12-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101144297 Medline TA: Scand J Surg Country: Finland |
Other Details:
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Languages: eng Pagination: 217-22 Citation Subset: IM |
Affiliation:
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Heart Center, Tampere University Hospital, Tampere University, Tampere, Finland. ari.mennander@pshp.fi |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Coronary Artery Bypass* Coronary Disease / surgery Debridement Female Humans Male Mediastinitis / etiology* Middle Aged Omentum / surgery Sternum / surgery Surgical Wound Infection / etiology*, surgery Treatment Failure |
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