Prevention of Sternal Dehiscence Following Use of Bilateral Internal Mammary Arteries in OPCAB  

Prevention of Sternal Dehiscence Following Use of Bilateral Internal Mammary Arteries in OPCAB

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作  者:Sandeep Singh Sarju Ralhan Aparesh Sanyal Frankleena Parage Varun Sisodia S. S. Lohchab Sandeep Singh;Sarju Ralhan;Aparesh Sanyal;Frankleena Parage;Varun Sisodia;S. S. Lohchab(Department of Cardiothoracic and Vascular Surgery, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences Rohtak, Universiy of Health Sciences, Rohtak, India;Department of Cardiothoracic and Vascular Surgery, Hero DMC Heart Institute, Dayanand Medical College, Ludhiana, India)

机构地区:[1]Department of Cardiothoracic and Vascular Surgery, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences Rohtak, Universiy of Health Sciences, Rohtak, India [2]Department of Cardiothoracic and Vascular Surgery, Hero DMC Heart Institute, Dayanand Medical College, Ludhiana, India

出  处:《World Journal of Cardiovascular Surgery》2020年第12期254-263,共10页心血管外科国际期刊(英文)

摘  要:<strong>Purpose:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">We harvested bilateral Internal Mammary Arteries and made LIMA-RIMA Y in all the patients undergoing OPCAB at our center irrespective of the presence or absence of various risk factors for sternal dehiscence. The purpose of this study was to find an effective way of sternal closure in patients undergoing OPCAB with both the Internal Mammary Arteries harvested for grafting. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">The patients who did not have any risk factors were placed in group I and all of them had a standard six wire closure of sternotomy. The patients having any risk factors were placed in group II. The patients in group II were randomized by including every alternate patient from group II to subgroup II A and every other alternate patient from group II to subgroup II B. Patients in subgroup II A again had a standard closure of sternotomy while in patients of subgroup II B bilateral Robiscek repair and four-five interlocking figure of eight wires were used for closure of sternotomy. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The patients who had risk factors for sternal dehiscence had higher risk for sternal dehiscence as compared to patients without any risk factors if bilateral Internal Mammary Arteries were harvested for OPCAB. But if we used bilateral Robiscek repair with four to five interlocking figure of eight wires for sternal closure then the rate of sternal complications in the patients with risk factors for sternal dehiscence was not more than the patients without risk factors. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> We can harvest bilateral Internal Mammary Arteries for OPCAB without fear of sternal complications even in patients with high risk for sternal dehiscence if we use bilateral Robiscek repair with four to five interlock<strong>Purpose:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">We harvested bilateral Internal Mammary Arteries and made LIMA-RIMA Y in all the patients undergoing OPCAB at our center irrespective of the presence or absence of various risk factors for sternal dehiscence. The purpose of this study was to find an effective way of sternal closure in patients undergoing OPCAB with both the Internal Mammary Arteries harvested for grafting. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">The patients who did not have any risk factors were placed in group I and all of them had a standard six wire closure of sternotomy. The patients having any risk factors were placed in group II. The patients in group II were randomized by including every alternate patient from group II to subgroup II A and every other alternate patient from group II to subgroup II B. Patients in subgroup II A again had a standard closure of sternotomy while in patients of subgroup II B bilateral Robiscek repair and four-five interlocking figure of eight wires were used for closure of sternotomy. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The patients who had risk factors for sternal dehiscence had higher risk for sternal dehiscence as compared to patients without any risk factors if bilateral Internal Mammary Arteries were harvested for OPCAB. But if we used bilateral Robiscek repair with four to five interlocking figure of eight wires for sternal closure then the rate of sternal complications in the patients with risk factors for sternal dehiscence was not more than the patients without risk factors. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> We can harvest bilateral Internal Mammary Arteries for OPCAB without fear of sternal complications even in patients with high risk for sternal dehiscence if we use bilateral Robiscek repair with four to five interlock

关 键 词:Robiscek Repair Interlocking Figure of Eight Wires Sternal Dehiscence Bilateral Internal Mammary Arteries 

分 类 号:R65[医药卫生—外科学]

 

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