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Ann Thorac Surg 2001;71:1888-1893
© 2001 The Society of Thoracic Surgeons

Original article: cardiovascular

Cardiac reoperation in the intensive care unit

Steven M. Fiser, MDa, Curtis G. Tribble, MDa, John A. Kern, MDa, Stewart M. Long, MDa, Aditya K. Kaza, MDa, Irving L. Kron, MDa

a Department of Thoracic and Cardiovascular Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia, USA

Address reprint requests to Dr Kron, Department of Thoracic and Cardiovascular Surgery, University of Virginia Health Sciences Center, Lee St, Rm 2753, Charlottesville, VA 22908
e-mail: ikron{at}virginia.edu

Presented at the Forty-seventh Annual Meeting of the Southern Thoracic Surgical Association Meeting, Marco Island, FL, Nov 9–11, 2000.

Background. At our institution, cardiac reoperations are routinely performed in the cardiac intensive care unit, as opposed to taking these patients back to the operating room. Our hypothesis was that reoperation in a cardiac intensive care unit does not increase sternal infection rate.

Methods. A retrospective analysis was performed on 6,908 adult patients undergoing cardiac operation over a 9-year period. Excluding those in cardiac arrest, 340 (4.9%) patients underwent reoperation in the cardiac intensive care unit, of which 289 survived (85%).

Results. Of the 289 patients who survived reoperation in the intensive care unit, 6 developed wound infections that required operative debridement (2.1%), which was not significantly different from those patients not requiring reoperation (1.9%, 121 of 6,497, p = 0.70). Hospital charges for a 2-hour reoperation in the intensive care unit and operating room are approximately $1,972/patient and $5,832/patient, respectively.

Conclusions. Reoperation in the intensive care unit does not increase wound infection rate compared to those without reoperation. Decreased charges, avoiding transport of potentially unstable patients, quicker time to intervention, and convenience are advantages of reoperation in an intensive care unit.






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Copyright © 2001 by The Society of Thoracic Surgeons.