Original articlePediatric cardiacRepeat Sternotomy in Congenital Heart Surgery: No Longer a Risk Factor
Section snippets
Material and Methods
The medical records of all repeat median sternotomies (n = 602) performed at TCH from October 2002 through July 2006 were retrospectively reviewed with the approval of the Baylor Institutional Review Board, which allowed individual consent to be waived given the retrospective nature of the study. Repeat sternotomy was defined as a sternotomy requiring the use of a saw to reopen the full length of the sternum and one that was at least 1 month after the prior sternotomy.
Results
Six hundred and two consecutive RS operations were performed on 558 patients. The incidence of RS over the study period was 32% (602 of 1,876). The median age at RS was 3.6 years (0.1 to 45.1), and the median weight was 14.2 kg (2.3 to 112.2 kg). The majority of the patients (35%) were between 3 and 10 years of age (Fig 1). Thirty-nine percent of the cohort was female. Bidirectional Glenn (22% [131]) was the most commonly performed procedure at RS, followed by Fontan's procedure (21% [129], 8
Comment
Repeat sternotomy in congenital heart surgery has always been prevalent because of the pathology, staged procedures, and the nature of palliation. However, with the success of neonatal repair and other palliative operations, the incidence of RS continues to increase. This has resulted in an exponential increase in adults with severe congenital heart disease, of whom the vast majority will need several operations [1]. In fact, the number of adults with severe congenital heart disease in 2002
References (8)
- et al.
Catastrophic hemorrhage on sternal reentry: still a dreaded complication?
Ann Thorac Surg
(1999) - et al.
Risks of repeat sternotomy in pediatric cardiac operations
Ann Thorac Surg
(1998) - et al.
Repeat median sternotomy in pediatrics: experience in 164 consecutive cases
Ann Thorac Surg
(1986) - Society of Thoracic Surgery Congenital Cardiac Surgery Database, January 2002 to December 2006; project manager Sean...
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