Poster Presentations: Tuesday, October 25, 2011 |

Rigid Sternal Fixation After Coronary Artery Bypass Graft Improves Postoperative Recovery FREE TO VIEW

Hitoshi Hirose, MD; Kentaro Yamane, MD; Linda Bogar, MD; Benjamin Youdelman, MD; Nicholas Cavarocchi, MD; James Diehl, MD
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Thomas Jefferson University, Philadelphia, PA

Chest. 2011;140(4_MeetingAbstracts):248A. doi:10.1378/chest.1080910
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PURPOSE: Rigid sternal fixation has known to provide better sternal closure than conventional sternal wire closure. We performed retrospective study whether or not the rigid sternal closure contribute patient outcomes in the patients after coronary artery bypass grafting.

METHODS: Retrospective chart review was conducted for the consecutive patients who underwent isolated coronary artery bypass grafting between 2009 and 2010 in our institution. Preoperative, perioperative, and follow-up data of patients with rigid fixation (group R, n=92) were collected and compared with those of patients with conventional sternal closure (group C, n=118). Univariate and multivariate analyses were performed to evaluate the dominant factor of postoperative recoveries. The factors included the analyses were; age, sex, coronary risk factors, urgency of surgery, ejection fraction, coronary anatomy, preoperative stroke, renal function, and preoperative presence of heart failure. All statistical analyses were performed by JMP software.

RESULTS: Group R was younger (61 ± 10 in group R vs 68 ± 11 in group C, p=0.0001) than group C, and more male dominates (87% vs 73%). Other risk factors including coronary risk factors, ejection fraction, and coronary anatomies, or urgency of surgery were not significantly different between 2 groups. Postoperatively, Sternal infection was occurred in 1 patient (1.6%) in group R and none in group C. Intubation time (13 ± 20 hours vs 34 ± 89 hours, p=0.0086), ICU stay (59 ± 48 hours vs 92 ± 110 hours, p=0.0035) and postoperative hospital stay (6.8 ± 3.2 days vs 8.2 ± 5.4 days, p=0.02) were significantly shorter in group R than group C. Multivariate analyses showed rigid sternal fixation was most dominant factor affecting intubation time, ICU stay, and postoperative stay.

CONCLUSIONS: Among the selected patient after coronary artery bypass grafting sternal stability provided by rigid sternal fixation facilitates recovery of the patients.

CLINICAL IMPLICATIONS: Solid stability of the sternum is one of the key factors of the early patient recovery after coronary artery bypass grafting.

DISCLOSURE: The following authors have nothing to disclose: Hitoshi Hirose, Kentaro Yamane, Linda Bogar, Benjamin Youdelman, Nicholas Cavarocchi, James Diehl

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