scholarly journals Impacts of Skeletonized Bilateral Internal Mammary Artery Bypass Grafting on the Risk of Deep Sternal Wound Infection

2020 ◽  
Vol 61 (2) ◽  
pp. 201-208
Author(s):  
Qiang Ji ◽  
Yun Zhao ◽  
Huan Liu ◽  
Ye Yang ◽  
YuLin Wang ◽  
...  
Keyword(s):  
Wound Infection ◽  
Internal Mammary Artery ◽  
Artery Bypass ◽  
Deep Sternal Wound Infection ◽  
Bypass Grafting ◽  
Sternal Wound Infection ◽  
Artery Bypass Grafting ◽  
Internal Mammary

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.

Management of the recurrent sternal wound infection

1995 ◽  
Vol 3 (3) ◽  
pp. 1-10
Author(s):  
Geoffrey G Hallock
Keyword(s):  
Wound Infection ◽  
Internal Mammary Artery ◽  
Selection Process ◽  
Artery Bypass ◽  
Muscle Flap ◽  
Bypass Grafting ◽  
Sternal Wound Infection ◽  
Flap Transfer ◽  
Accepted Standard ◽  
Internal Mammary

After adequate sternal debridement or resection for the treatment of a sternal wound infection, muscle flap obliteration of the resulting void has become an accepted standard. Unfortunately, recurrence is not an inconsequential risk as evidenced in six (20.7%) of our patients over the last 10 years. Two of these patients required a second muscle flap transfer before obtaining a healed wound. Since the available regional options for appropriate vascularized flaps is limited, especially with the increased frequency in use of the internal mammary artery for coronary artery bypass grafting, great care must be observed in the selection process not just for closure of the initial wound, but in anticipation of untoward sequela. A schema prioritizing alternatives has been established, so as to maximize the benefit of our workhorse flaps, the pectoralis major or rectus abdominis muscles.

scholarly journals Risk Factors for Deep Sternal Wound Infection after Coronary Artery Bypass Grafting

2007 ◽  
Vol 36 (4) ◽  
pp. 175-179
Author(s):  
Hidetoshi Masumoto ◽  
Mitsuomi Shimamoto ◽  
Fumio Yamazaki ◽  
Masanao Nakai ◽  
Shoji Fujita ◽  
...  
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

scholarly journals Bilateral Internal Mammary Artery Bypass Grafting: Sternal Wound Infection in High-Risk Population. Should Sternal Infection Scare Us?

2018 ◽  
Vol 10 ◽  
pp. 117906521878937 ◽  
Author(s):  
Justine Mafalda Ravaux ◽  
Thami Guennaoui ◽  
Christian Mélot ◽  
Peter Schraverus
Keyword(s):  
High Risk ◽  
Wound Infection ◽  
Artery Bypass ◽  
High Risk Population ◽  
Bypass Grafting ◽  
Sternal Wound Infection ◽  
Risk Population ◽  
Artery Bypass Grafting ◽  
Mammary Arteries ◽  
Internal Mammary

Background: Bilateral internal mammary arteries (BIMAs) remain underused in coronary artery bypass grafting (CABG), especially in elderly, diabetic, and obese patients. This study investigated incidence of sternal wound infection (SWI), sternal instability (SI), and reintervention for bleeding (RIB) in this high-risk population. Methods: A single-center retrospective observational study was performed in “Grand Hôpital de Charleroi, Gilly, Belgium.” A total of 319 patients undergoing CABG from December 2011 to December 2015 were included. Three main outcome measures (SWI, SI, and RIB) were investigated in obese vs nonobese, diabetic vs nondiabetic, and elderly vs younger patients. Results: In all, 14 SWI, 11 SI, and 6 RIB were discounted. Death rate was as follows: SWI: 2/14 vs 17/305 ( P = .178), SI: 2/11 vs 17/308 ( P = .081), and RIB: 2/6 vs 17/313 ( P = .004). In obese (n = 113) vs nonobese (n = 206) patients, there was no difference for SWI ( P = .263), SI ( P = .565), and RIB ( P = .332). In diabetic (n = 118) vs nondiabetic (n = 201) patients, there was no difference for SWI ( P = .642), SI ( P = .497), and RIB ( P = .298). In elderly (n = 62) vs younger (n = 257) patients, there was no difference for SWI ( P = .619), SI ( P = .915), and RIB ( P = .385). Conclusions: Obesity, age, and diabetes treated by insulin (or not) do not seem to be risk factors for developing SWI, SI, or RIB in patients receiving a CABG using BIMA. Nevertheless, mortality was higher in RIB group.

Mitral Valve Replacement via Anterolateral Right Thoracotomy without Cross-Clamping in a Patient with Fungal Infective Endocarditis and Functioning Internal Mammary Artery after Previous Coronary Artery Bypass Grafting and Mitral Valve Repair

2016 ◽  
Vol 19 (1) ◽  
pp. 033
Author(s):  
Takahiro Taguchi ◽  
Jeswant Dillon ◽  
Mohd Azhari Yakub
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Mitral Valve ◽  
Coronary Artery Bypass ◽  
Internal Mammary Artery ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Valve Repair ◽  
Artery Bypass Grafting ◽  
Internal Mammary

A 55-year-old man developed severe mitral regurgitation with persistent fungal infective endocarditis 8 months after coronary artery bypass grafting with a left internal mammary artery and 2 saphenous veins, as well as mitral valve repair with a prosthetic ring. Echocardiography demonstrated severe mitral regurgitation and a valvular vegetation. Computed tomography coronary arteriography indicated that all grafts were patent and located intimately close to the sternum. Median resternotomy was not attempted due to the risk of injury to the bypass grafts, and therefore, a right anterolateral thoracotomy approach was utilized. Mitral valve replacement was performed with the patient under deep hypothermia and ventricular fibrillation without aortic cross-clamping. The patient`s postoperative course was uneventful. Thus, right anterolateral thoracotomy may be a superior approach to mitral valve surgery in patients who have undergone prior coronary artery bypass grafting.

Internal Mammary Artery Bypass Grafting in Left Main Stenosis

Cardiology ◽  
1993 ◽  
Vol 82 (5) ◽  
pp. 343-346
Author(s):  
Reinhard H&ouml;ltgen ◽  
Ruud Krijne ◽  
Karl-Wilhelm Heinrich ◽  
Hermann Sons ◽  
Arno Krian
Keyword(s):  
Internal Mammary Artery ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Left Main ◽  
Artery Bypass Grafting ◽  
Left Main Stenosis ◽  
Internal Mammary

The use of free versus in situ right internal mammary artery in coronary artery bypass grafting

2021 ◽  
Author(s):  
Edgar Aranda‐Michel ◽  
Derek Serna‐Gallegos ◽  
Forozan Navid ◽  
Arman Kilic ◽  
Abraham A. Williams ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Internal Mammary Artery ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Internal Mammary
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