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KMID : 0364019950280110977
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Korean Journal of Thoracic and Cardiovascular Surgery
1995 Volume.28 No. 11 p.977 ~ p.982
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Delayed Stemal Closure after Open Heart Surgery in Neonate
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성시찬
이용훈/조은희/전희재/최필조/우종수
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Abstract
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Early repair of complex congenital heart malformation may lead to life-threatening respiratory and hemodynamic embarrassment on sternal closure. We performed delayed sternal closure in nine neonates to avoid a fatal outcome in these situations.
Primary
elective open sternal closure in nine neonates to avoid a fatal outcome in these situations. Primary elective open sternum was used in 8 (66.7%) and primary sternal closure in 4 (33.3%) of the 12 patients studied. A patient with primary sternal
closure
underwent delayed sternal reopening in the intensive care unit. Of the 9 patients with open sternum, 2 patients died of low cardiac output and acute renal failure respectively before delayed sternal closure. 7 patients could undergo delayed
sternal
closures 3 days after initial operation. The mean age at open cardiac procedure was 14.3 days (range 3 to 30) and mean preoperative weight was 3.4kg (range 2.8 to 4.1). The aortic cross-clamping time was longer in the group with open sternum than
the
group with closed sternum (p=0.042). There was no morbidity and mortality related to delayed sternal closure. Given the low morbidity and potential benifits, this technique should be used in neonates after open heart procedures when postoperative
mediastinal compression produces frank low cardiac output or respiratoy compromise during a trial of sternal closure.
(Korean J Thorac Cardiovasc Surg 1995;28:977-82)
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