| Resternotomy using hypothermic arrest. | |
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MedLine Citation:
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PMID: 20202027 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Resternotomy during closed chest cardiopulmonary bypass in hypothermia with or without circulatory arrest has been the preferred method for cardiac reoperations with adherent structures to the sternum. Here, we report our experience with this method and the effects of omitting ventricular decompression during the cooling procedure. METHODS: Twenty reoperations were performed in 19 patients. In half (n = 10) of the procedures aortic regurgitation was present. Cardiopulmonary bypass was instituted in all patients before resternotomy, and the re-entry into the chest was performed either under hypothermic low-flow cardiopulmonary bypass or circulatory arrest. The reason for this choice of technique was adherent structures to the sternum posing a substantial risk for rupture during resternotomy in all patients. RESULTS: Rupture upon re-entry into the chest occurred in five operations. No patient died due to re-entry injury. The overall hospital mortality was 15%. No differences in postoperative outcomes including heart failure, biochemical markers indicating myocardial damage, and three-month follow-up assessment of cardiac function were found between patients with aortic regurgitation and patients without aortic regurgitation. CONCLUSIONS: Based on our experience, omitting ventricular decompression in resternotomy in hypothermia and arrested circulation or low-flow cardiopulmonary bypass can be safely used, and the presence of aortic regurgitation does not seem to influence the outcome. |
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Authors:
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Fanny Möller; Jan Liska; Ulf Lockowandt; Sten Samuelsson; Anders Franco-Cereceda |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-02-23 |
Journal Detail:
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Title: Journal of cardiac surgery Volume: 25 ISSN: 1540-8191 ISO Abbreviation: J Card Surg Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-06-11 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8908809 Medline TA: J Card Surg Country: United States |
Other Details:
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Languages: eng Pagination: 272-6 Citation Subset: IM |
Affiliation:
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Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. fanny.moller@ki.se |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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