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Deep Sternal Wound Infection After Beating Heart Coronary Artery Bypass Surgery with Routine Use of Skeletonized Bilateral Internal Thoracic Artery
Magalhães, Daniel M. S.; Deininger, Maurilio O.; Oliveira, Orlando Gomes de; Freitas, John Allexander de; Deininger, Eugênia di Giuseppe.
Afiliação
  • Magalhães, Daniel M. S.; Hospital Unimed João Pessoa - Alberto Urquiza Wanderley. João Pessoa. BR
  • Deininger, Maurilio O.; Hospital Unimed João Pessoa - Alberto Urquiza Wanderley. João Pessoa. BR
  • Oliveira, Orlando Gomes de; Hospital Unimed João Pessoa - Alberto Urquiza Wanderley. João Pessoa. BR
  • Freitas, John Allexander de; Hospital Unimed João Pessoa - Alberto Urquiza Wanderley. João Pessoa. BR
  • Deininger, Eugênia di Giuseppe; Hospital Unimed João Pessoa - Alberto Urquiza Wanderley. João Pessoa. BR
Rev. bras. cir. cardiovasc ; Rev. bras. cir. cardiovasc;38(4): e20210607, 2023. tab
Article em En | LILACS-Express | LILACS | ID: biblio-1449560
Biblioteca responsável: BR1.1
ABSTRACT
ABSTRACT

Introduction:

Despite its survival benefits, bilateral internal thoracic artery (BITA) grafting is not commonly utilized due to concerns over deep sternal wound infection (DSWI). We observed the role of routine use of BITA and off-pump coronary artery bypass grafting (OPCABG) in the incidence of DSWI and associated risk factors.

Methods:

Between January 2010 and December 2020, 1,207 patients were treated with isolated coronary artery bypass grafting. In all cases, OPCABG was attempted, and BITA was used whenever there was a need for a second arterial graft for the left coronary artery. DSWI was defined as a wound infection requiring surgical intervention and/or the administration of antibiotics. Multiple linear regression analysis was employed to model the risk of DSWI.

Results:

The incidence of DSWI was 0.58%. Mortality rate was higher in DSWI group than in no-DSWI group (28.57% vs. 1.25%; P<0.001). No significant difference in DSWI incidence was observed when BITA (70.6%) or single internal thoracic artery (29.4%) were used (P=0.680). The prevalence of diabetes (100% vs. 40.7%; P=0.001), hyperlipidemia (100% vs. 85.9%; P=0.045), and obesity (71.4% vs. 26.8%; P-0.017) was significantly elevated in DSWI group, when compared with no-DSWI group. Diabetes (P=0.0001), unstable angina (P=0.0064), previous myocardial infarction > 30 days (P=0.0009), left ventricular ejection fraction < 50% (P=0.0074), and emergency surgery (P=0.0002) were independent risk factors.

Conclusion:

The results of routine use of skeletonized BITA after OPCABG were satisfactory regarding DSWI incidence and operative mortality in a single-center experience.
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Tipo de estudo: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Rev. bras. cir. cardiovasc Assunto da revista: CARDIOLOGIA / CIRURGIA GERAL Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Tipo de estudo: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Rev. bras. cir. cardiovasc Assunto da revista: CARDIOLOGIA / CIRURGIA GERAL Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil