When Should the Sternum Be Closed After Aortic Surgery?

Abstract

Introduction: There are many factors affecting postoperative morbidity and mortality in patients managed with delayed sternal closure (DSC) after aortic surgery. This study aimed to examine the postoperative management of patients after DSC and the factors affecting morbidity and mortality. Patients and Methods: Among 2151 patients who underwent ascending aorta and/or aortic valve surgery between January 2012 and December 2020, 64 patients managed with DSC were included in the study. The records of the patients were obtained from the hospital archive/hospital electronic database. Postoperative day 30 was determined as early mortality. Results: Uncontrollable bleeding 34.4% (n= 22), LCOS (Low Cardiac Output Syndrome) 31.4% (n= 20) and mediastinal edema 28.1% (n= 18)were the main causes for DSC. In the remaining patients (6.3%, n= 4), DSC was preferred for other non-specific reasons such as uncontrollable arrhythmia. Forty-five patients’ chests (70.3%) were closed in the postoperative period, and 19 patients (29.7%) could not be closed due to death (p 0.05). However, the closure time was longer in patients with a previous operation history, postoperative acute renal failure, surgical site infection, and postoperative bleeding revision/surgical revision (p