EVALUATION OF OPEN CHEST MANAGEMENT (OCM) WITH DELAYED STERNAL CLOSURE (DSC) AFTER CARDIAC SURGERY

Abstract

Objective: In this study, we evaluated the open chest management (OCM) withdelayed sternal closure (DSC) after cardiac surgery. Methodology: A total of 22721 patients who underwent open heart operation wereincluded in the study. Delayed sternal closure was performed in 362 (1.5%)patients with mean age of 59.01 ± 12.4 years. Males were 63% (n=229).Therate of DSC was 1.5% and was performed because of the hemodynamicinstability, bleeding, arrhythmia, tamponade and aortic dissection. The mortalityrate was 28.5%. Diabetes and emergency status of the operation were twopredictors of mortality (p<0.001). Moreover, analysis pointed out that diabetes;severe chronic lung disease and postoperative need for hemodialysis were thestrongest independent predictors of mortality in patients under going opensurgery with DSC. The most prevalent post operation, complications were atrialfibrillation, bleeding, pulmonary embolism and new onset renal failure withincidence rates of 38.4% (139), 26.2% (95), 15.2% (55), and 9.1% (33)respectivelyT Result: A total of 22721 patients who underwent open heart operation wereincluded in the study. Delayed sternal closure was performed in 362 (1.5%)patients with mean age of 59.01 ± 12.4 years. Males were 63% (n=229).Therate of DSC was 1.5% and was performed because of the hemodynamicinstability, bleeding, arrhythmia, tamponade and aortic dissection. The mortalityrate was 28.5%. Diabetes and emergency status of the operation were twopredictors of mortality (p<0.001). Moreover, analysis pointed out that diabetes;severe chronic lung disease and postoperative need for hemodialysis were thestrongest independent predictors of mortality in patients under going opensurgery with DSC. The most prevalent post operation, complications were atrialfibrillation, bleeding, pulmonary embolism and new onset renal failure withincidence rates of 38.4% (139), 26.2% (95), 15.2% (55), and 9.1% (33)respectively. Conclusion: The hemodynamic instability, bleeding, arrhythmia, tamponade andaortic dissection were the most important factors for the performance of DSCwhile diabetes and emergency status of the operation were the most importantpredictors of mortality. Key Words: Open chest management , Delayed sternal closure , Cardiac surgery,Open sternum.