scholarly journals Omental Herniation: A Rare Complication of Vacuum-Assisted Closure of Infected Sternotomy Wound

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Philemon Gukop ◽  
Madhan Kumar Kuppuswamy ◽  
Antonios Kourliouros ◽  
Venkatachalam Chandrasekaran
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Rare Complication ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Wound Infections ◽  
Sternal Wound Infection ◽  
Vacuum Assisted Closure ◽  
First Case ◽  
Omental Herniation

Vacuum-assisted closure (VAC) has recently been adopted as an acceptable modality for management of sternotomy wound infections. Although generally efficacious, the use of negative pressure devices has been associated with complications such as bleeding, retention of sponge, and empyema. We report the first case of greater omental hernia as a rare complication of vacuum-assisted closure of sternal wound infection following coronary artery bypass grafting.

scholarly journals Risk Factors Associated with an Increased Risk of Deep Sternal Wound Infections in Patients After Coronary Artery Bypass Grafting and Heart Defect Surgery

2021 ◽  
Vol 24 (4) ◽  
pp. E741-E745
Author(s):  
Miglė Vitartaitė ◽  
Donata Vaičiulytė ◽  
Jonė Venclovienė ◽  
Edmundas Širvinskas ◽  
Rasa Bukauskienė ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Wound Infection ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Deep Sternal Wound Infection ◽  
Bypass Grafting ◽  
Sternal Wound Infection ◽  
Artery Bypass Grafting

Background: Despite improvements over time with regard to morbidity, mortality, and long-term survival, deep sternal wound infection (DSWI) continues to be a major complication after open-heart surgery. This is why it is important to identify possible risk factors for postoperative development of DSWI in patients undergoing coronary artery bypass grafting and valve replacement. The aim of this study was to identify the risk factors for postoperative development of deep sternal wound infection in patients after coronary artery bypass grafting and heart defect surgery at the Department of Thoracic, Cardiac, and Vascular Surgery of the Hospital of Lithuanian University of Health Sciences. Methods: This retrospective study analyzed 201 patients, who underwent coronary artery bypass grafting and heart defect surgery between January 2017 and December 2018. The case group contained 45 patients, who had to be reoperated because of deep sternal wound infection, and the control group consisted of 156 randomly selected patients. For descriptive statistics, we used means, median values, ranges, standard deviations, and 95% confidence intervals, where appropriate. Categorical data were analyzed using the chi-square or Fisher’s exact test. Student T-test and Mann-Whitney used to compare numerical variables. Logistic regression model adjusting for age and gender was used to compare the risk of infection. A P-value of < 0.05 was considered to be statistically significant. SPSS 26.0 was used for calculations. Results: Logistic regression analysis revealed that independent risk factors for sternal wound infection were high BMI (odds ratio [OR] 1.15, CI 1.06-1.24), preoperative CRP (OR 1.08, CI 1.01-1.16), long duration of cardiopulmonary bypass (OR 1.02, CI 1.01-1.03), intraoperative anemia (OR 0.97, CI 0.95-0.99), and postoperative CRP concentration (OR 1.10; CI 1.05-1.16). Conclusions: Preoperative assessment to identify obese individuals as being at risk and techniques to minimize the duration of surgery and intraoperative blood loss may help reduce postoperative deep sternal wound infections.

Preoperative risk stratification of deep sternal wound infection after coronary surgery

2020 ◽  
Vol 41 (4) ◽  
pp. 444-451
Author(s):  
Fausto Biancari ◽  
Giuseppe Gatti ◽  
Stefano Rosato ◽  
Giovanni Mariscalco ◽  
Aniello Pappalardo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Risk Score ◽  
Artery Bypass ◽  
Deep Sternal Wound Infection ◽  
Bypass Grafting ◽  
Sternal Wound Infection ◽  
Validation Data ◽  
Data Set ◽  
Additive Risk

AbstractObjective:To develop a risk score for deep sternal wound infection (DSWI) after isolated coronary artery bypass grafting (CABG).Design:Multicenter, prospective study.Setting:Tertiary-care referral hospitals.Participants:The study included 7,352 patients from the European multicenter coronary artery bypass grafting (E-CABG) registry.Intervention:Isolated CABG.Methods:An additive risk score (the E-CABG DSWI score) was estimated from the derivation data set (66.7% of patients), and its performance was assessed in the validation data set (33.3% of patients).Results:DSWI occurred in 181 (2.5%) patients and increased 1-year mortality (adjusted hazard ratio, 4.275; 95% confidence interval [CI], 2.804–6.517). Female gender (odds ratio [OR], 1.804; 95% CI, 1.161–2.802), body mass index ≥30 kg/m2 (OR, 1.729; 95% CI, 1.166–2.562), glomerular filtration rate <45 mL/min/1.73 m2 (OR, 2.410; 95% CI, 1.413–4.111), diabetes (OR, 1.741; 95% CI, 1.178–2.573), pulmonary disease (OR, 1.935; 95% CI, 1.178–3.180), atrial fibrillation (OR, 1.854; 95% CI, 1.096–3.138), critical preoperative state (OR, 2.196; 95% CI, 1.209–3.891), and bilateral internal mammary artery grafting (OR, 2.088; 95% CI, 1.422–3.066) were predictors of DSWI (derivation data set). An additive risk score was calculated by assigning 1 point to each of these independent risk factors for DSWI. In the validation data set, the rate of DSWI increased along with the E-CABG DSWI scores (score of 0, 1.0%; score of 1, 1.8%; score of 2, 2.2%; score of 3, 6.9%; score ≥4: 12.1%; P < .0001). Net reclassification improvement, integrated discrimination improvement, and decision curve analysis showed that the E-CABG DSWI score performed better than other risk scores.Conclusions:DSWI is associated with poor outcome after CABG, and its risk can be stratified using the E-CABG DSWI score.Trial registration:clinicaltrials.gov identifier: NCT02319083

scholarly journals Rare Cause of Late Recurrent Angina following Coronary Artery Bypass Grafting: Iatrogenic Aortocoronary Arteriovenous Fistula Causing Coronary Steal

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Jayakumar Sreenivasan ◽  
Muhammad Ayub ◽  
Neha Yadav ◽  
Yasmeen Golzar
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Arteriovenous Fistula ◽  
Coronary Artery Bypass ◽  
Left Internal Mammary Artery ◽  
Rare Complication ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Recurrent Angina

Iatrogenic aortocoronary arteriovenous fistula is a very rare complication of coronary artery bypass grafting in which one of the arterial grafts inadvertently forms a fistulous tract with a cardiac vein, shunting blood from the anastomosed coronary artery. We report a patient with an iatrogenic left internal mammary artery graft to cardiac vein fistula presenting with recurrent angina three years after a three-vessel coronary artery bypass grafting.

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