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The Journal of Thoracic and Cardiovascular Surgery, Vol 69, 138-143, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Surgical considerations in patients undergoing repeat median sternotomy

Q Macmanus, JE Okies, SJ Phillips and A Starr

A retrospective review of 122 repeat median sternotomy incisions in 100 consecutive patients was made to evaluate complications and management. Eighty-one patients had one repeat sternotomy, )6 had two repeat sternotomies, and 3 had three repeat sternotomies. All had valve procedures in the past and were reoperated upon for progressive rheumatic valvular disease or for complications related to the prostheses. Complications included operative hemorrhage in 8 patients, postoperative hemorrhage in 2, seroma in 4, and dehiscence, wound infection, and hematoma in 1 patient each. The most serious complication was hemorrhage and was the cause of the only operative death. Seven other patients survived hemorrhage encountered during repeat sternotomy. Control of massive hemorrhage during repeat sternotomy has been possible due to an organized approach to the patient with adhesions from previous surgery.


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