| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1981;32:273-277
© 1981 The Society of Thoracic Surgeons
Department of Thoracic and Cardiovascular Surgery, Newark Beth Israel Medical Center, Newark, NJ
* Address reprint requests to Dr. Gielchinsky, Department of Thoracic and Cardiovascular Surgery, Newark Beth Israel Medical Center, 201 Lyons Ave, Newark, NJ 07112
Between June, 1976, and December, 1980, 29 patients underwent delayed sternal closure at the Newark Beth Israel Medical Center. The indications were enlarged heart with tamponade when the mediastinum was closed, poor lung compliance, hemodynamic instability due to intractable arrhythmias or coagulopathy, and presence of a mediastinal assist device.
Following an open-heart procedure, the retrosternal space may no longer accommodate the heart and approximation of the sternum will produce hypotension and elevation of right and left end-diastolic pressures. In such instances, only the skin is closed and between one to four days later, the wound is closed in a routine manner.
There are several advantages of the procedure: hemodynamic stability; quick access to the heart for massage or evacuation of clots; and possibility of removing an intraaortic balloon in the ascending aorta without leaving a large Dacron tube. Of the 29 patients treated, 19 were long-term survivors and only 1 patient had a minor superficial wound infection.
Although it is not recommended that this procedure be utilized routinely or indiscriminately, its judicious use will add flexibility in the management of selected and difficult cases.
This article has been cited by other articles:
|
|
 |
|
  U. Boeken, A. Assmann, A. Mehdiani, P. Akhyari, and A. Lichtenberg Open chest management after cardiac operations: outcome and timing of delayed sternal closure Eur J Cardiothorac Surg, November 1, 2011; 40(5): 1146 - 1150. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. J. Shin, W. K. Jhang, J.-J. Park, and T.-J. Yun Impact of Delayed Sternal Closure on Postoperative Infection or Wound Dehiscence in Patients With Congenital Heart Disease Ann. Thorac. Surg., August 1, 2011; 92(2): 705 - 709. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Pye and M. McDonnell Nursing Considerations for Children Undergoing Delayed Sternal Closure After Surgery for Congenital Heart Disease Crit. Care Nurse, June 1, 2010; 30(3): 50 - 61. [Full Text] [PDF]
|
|
|
|
 |
|
 T. Fleck, B. Kickinger, R. Moidl, F. Waldenberger, E. Wolner, M. Grabenwoger, and W. Wisser Management of open chest and delayed sternal closure with the vacuum assisted closure system: preliminary experience Interact CardioVasc Thorac Surg, October 1, 2008; 7(5): 797 - 804. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Riphagen, M. McDougall, S. M. Tibby, N. Alphonso, D. Anderson, C. Austin, A. Durward, and I. A. Murdoch "Early" Delayed Sternal Closure Following Pediatric Cardiac Surgery Ann. Thorac. Surg., August 1, 2005; 80(2): 678 - 684. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Belenkie, R. Sas, J. Mitchell, E. R. Smith, and J. V. Tyberg Opening the pericardium during pulmonary artery constriction improves cardiac function J Appl Physiol, March 1, 2004; 96(3): 917 - 922. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. A. Anderson, F. Filsoufi, L. Aklog, R. S. Farivar, J. G. Byrne, and D. H. Adams Liberal use of delayed sternal closure for postcardiotomy hemodynamic instability Ann. Thorac. Surg., May 1, 2002; 73(5): 1484 - 1488. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Samir, A. Riberi, O. Ghez, M. Ali, D. Metras, and B. Kreitmann Delayed sternal closure: a life-saving measure in neonatal open heart surgery; could it be predictable? Eur J Cardiothorac Surg, May 1, 2002; 21(5): 787 - 793. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Mubeen, S. Dan, S. K. Agarwal, A. K. Srivastava, and V. M Kanhere Delayed Sternal Closure After Cardiac Operations Asian Cardiovasc Thorac Ann, June 1, 2001; 9(2): 82 - 85. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. K. Thyagarajan and A. Cobanoglu Temporary Stenting of the Sternum After Difficult Cardiac Operations Ann. Thorac. Surg., November 1, 1997; 64(5): 1504 - 1505. [Abstract] [Full Text]
|
|
|
|
 |
|
 S. Tabbutt, B. W. Duncan, D. McLaughlin, D. L. Wessel, R. A. Jonas, and P. C. Laussen DELAYED STERNAL CLOSURE AFTER CARDIAC OPERATIONS IN A PEDIATRIC POPULATION J. Thorac. Cardiovasc. Surg., May 1, 1997; 113(5): 886 - 893. [Abstract] [Full Text]
|
|
|
|
|
|
R. S. Iyer, J. P. Jacobs, M. R. de Leval, J. Stark, and M. J. Elliott Outcomes After Delayed Sternal Closure in Pediatric Heart Operations: A 10-Year Experience Ann. Thorac. Surg., February 1, 1997; 63(2): 489 - 491. [Abstract] [Full Text]
|
|
|
|
|
|
H. Satoh, K. Sakai, M. Koyama, and H. Matsuda Spool-Like Stent for the Open Sternum After Cardiac Operations Ann. Thorac. Surg., February 1, 1997; 63(2): 572 - 574. [Abstract] [Full Text]
|
|
|
|
|
|
J. P. Geiger, C. A. Tabak, and E. M. Aronstam Primary Sternal Closure and Mediastinal Decompression by Inlay Autologous Rib Grafts Ann. Thorac. Surg., January 1, 1996; 61(1): 215 - 216. [Abstract] [Full Text]
|
|
|
|
|
|
M. T. McEnany Sternal traction after open heart operation: An effective alternative to delayed sternal closure Ann. Thorac. Surg., August 1, 1995; 60(2): 387 - 391. [Abstract] [PDF]
|
|
|
|
 |
|
 S. Shimokawa, H. Toyohira, H. Saigenji, S. Fukuda, Y. Moriyama, M. Koga, H. Iwamura, R. Toda, H. Masuda, and A. Taira Delayed Sternal Closure Following Operation of Type-A Acute Aortic Dissection Vascular and Endovascular Surgery, July 1, 1995; 29(4): 281 - 285. [Abstract] [PDF]
|
|
|
|
|
|
V. Alexi-Meskishvili, Y. Weng, F. Uhlemann, P. E. Lange, and R. Hetzer Prolonged open sternotomy after pediatric open heart operation: Experience with 113 patients Ann. Thorac. Surg., February 1, 1995; 59(2): 379 - 383. [Abstract] [PDF]
|
|
|
|
|
|
A. Elami, L. C. Permut, H. Laks, D. C. Drinkwater Jr, and J. L. Sebastian Cardiac decompression after operation for congenital heart disease in infancy Ann. Thorac. Surg., November 1, 1994; 58(5): 1392 - 1396. [Abstract] [PDF]
|
|
|
|
|
|
S. D. Jones, D. A. Fullerton, D. N. Campbell, J. Jaggers, J. M. Brown, R. Smith, and F. L. Grover Technique to stent the open sternum after cardiac operations Ann. Thorac. Surg., October 1, 1994; 58(4): 1186 - 1187. [Abstract] [PDF]
|
|
|
|
|
|
M. Hakimi, H. L. Walters III, W. W. Pinsky, M. J. Gallagher, and J. M. Lyons Delayed sternal closure after neonatal cardiac operations J. Thorac. Cardiovasc. Surg., March 1, 1994; 107(3): 925 - 933. [Abstract] [Full Text]
|
|
|
|
|
|
H. Yokoyama, T. Togo, S. Murata, K. Osaka, M. Miura, K. Tabayashi, and H. Mohri Cardiac dilatation after cardiopulmonary bypass: Ceramic plate technique for sternal splinting Ann. Thorac. Surg., October 1, 1993; 56(4): 971 - 972. [Abstract] [PDF]
|
|
|
|
|
|
A. P. Furnary, J. A. Magovern, K. A. Simpson, and G. J. Magovern Prolonged open sternotomy and delayed sternal closure after cardiac operations Ann. Thorac. Surg., August 1, 1992; 54(2): 233 - 239. [Abstract] [PDF]
|
|
|
|
|
|
C. A. Mestres, J. L. Pomar, M. Acosta, S. Ninot, C. Barriuso, C. Abad, and J. Mulet Delayed sternal closure for life-threatening complications in cardiac operations: An update Ann. Thorac. Surg., May 1, 1991; 51(5): 773 - 776. [Abstract] [PDF]
|
|
|
|
|
|
J. A. Johnson, A. E. Gundersen, I. D. Stickney, and T. H. Cogbill Selective approach to sternal closure after exploration for hemorrhage following coronary artery bypass Ann. Thorac. Surg., May 1, 1990; 49(5): 771 - 774. [Abstract] [PDF]
|
|
|
|
|
|
W. J. Fanning, J. S. Vasko, and J. W. Kilman Delayed Sternal Closure after Cardiac Surgery Ann. Thorac. Surg., August 1, 1987; 44(2): 169 - 172. [Abstract] [PDF]
|
|
|
|
|
|
P. Fundaro, E. Santoli, F. Scribani Rossi, M. Botta, and C. Santoli Partial Pericardiectomy to Prevent Cardiac Compression in Open-Heart Surgery Ann. Thorac. Surg., May 1, 1986; 41(5): 581 - 583. [PDF]
|
|
|
|
|
|
D. A. Murphy Delayed Closure of the Median Sternotomy Incision Ann. Thorac. Surg., July 1, 1985; 40(1): 76 - 77. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
