Delayed sternal closure following open heart surgery in children

Tolga Tatar,

doi:10.5606/tgkdc.dergisi.2012.049

Tolga Tatar¹, Murat Özkan², Süleyman Özkan³, Bülent Sarıtaş², Oktay Korun², Sait Aşlamacı²

¹Department of Cardiovascular Surgery, Medicine Faculty of Gazi University, Ankara, Turkey
²Department of Cardiovascular Surgery, Medicine Faculty of Başkent University, Ankara, Turkey
³Department of Cardiovascular Surgery, Medicine Faculty of Acıbadem University, İstanbul, Turkey

DOI : 10.5606/tgkdc.dergisi.2012.049

Background: In this article, we reviewed the clinical results of patients in which delayed sternum closing was performed following neonatal open-heart surgery.

Methods: Between April 2008 and April 2011, delayed sternum closure was performed for 142 of 1416 pediatric open-heart operations. Mortality and wound infection rates as well as duration of mechanical ventilation were assessed in this patient group with a mean body weight of 3.55 kg and mean age of 33 days.

Results: In-hospital mortality rate was found to be 31.6% (n=45) of a total of 142 patients whose sternum remained open. The mean time to close sternum was 44 hours in 97 survivors. Only one patient developed mediastinitis, while four patients (4% of survivors) developed superficial wound infection. The mean length of stay on mechanical ventilation was 102 hours.

Conclusion: Although delayed sternum closure is not a new application, it deserves a special attention because of the increasing incidence of neonatal open heart surgery and thanks to its unique advantages.

Keywords : Cardiac surgery; intensive care; pediatrics

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