• J Coll Physicians Surg Pak · Sep 2021

    Does Sternal Cable System Prevent Sternal Complications after Revision Sternal Surgery?

    • Levent Altınay, Elif Coşkun Sungur, Anil Özen, Anıl Tekin, Sıtkı Akın Turan, Görkem Yiğit, and Ufuk Tütün.
    • Department of Cardiovascular Surgery, Dışkapı Education and Research Hospital, Ankara, Turkey.
    • J Coll Physicians Surg Pak. 2021 Sep 1; 31 (9): 1069-1074.

    ObjectiveTo determine the efficacy of a sternal wire system in secondary sternal dehiscence after repeat closure of the sternum, following surgical revision after open heart surgery.Study DesignCase-control study.Place And Duration Of StudyDepartment of Cardiovascular Surgery, Zonguldak Bülent Ecevit University, Zonguldak, Turkey; and Turkey Yuksek Ihtisas Training and Research Hospital, Turkey, from January 2015 to May 2019.MethodologyPatients, who underwent open heart surgery with median sternotomy, were included in this retrospective study. The patients were divided into two groups, according to the sternal closure material. The time of the sternal reconstruction surgery, because of sternal dehiscence, fracture, broken sternal wire(s) or cable(s) after the first revision surgery, was noted for each patient.ResultsA total of 389 patients were identified. Group 1 included 72 (50%) patients whose sternums were closed with a sternal cable system; and Group 2 included 72 (50%) patients whose sternums were closed with conventional steel wires after propensity matching. The duration of cardiopulmonary bypass, number of intra-aortic balloon pumps used, and number of extracorporeal membrane oxygenators used were significantly higher in Group 1 (p = 0.007, p = 0.034, and p = 0.028, respectively). The number of emergency operations was significantly higher in Group 2 (p = 0.021). There was no significant difference in terms of secondary sternal dehiscence between the groups (p = 0.366).ConclusionApplication of the sternal wire system in revisional open heart surgery is not more effective than conventional steel wire at preventing secondary sternal dehiscence. Key Words: Sternal dehiscence, Sternal cable, Sternal wire, Open heart surgery, Postoperative revision.

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