Clinical Evaluation of Delayed Sternal Closure following Open Heart Surgery in Neonates and Infants.
10.4326/jjcvs.21.149
- VernacularTitle:新生児乳児期開心術後におけるシリコンラバーを用いた二期的胸骨閉鎖法に関する臨床的検討
- Author:
Masanao IMAI
;
Masahiro YAMAGUCHI
;
Hidetaka OHASHI
;
Yoshihiro OSHIMA
;
Naoki YOSHIMURA
;
Tatsuro SATO
;
Masahisa UEMATSU
;
Yuhei HOSOKAWA
;
Hideo TACHIBANA
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1992;21(2):149-154
- CountryJapan
- Language:Japanese
-
Abstract:
The cases of neonates and infants who underwent successful delayed sternal closure (DSC) using silastic rubber after open heart surgery were reviewed. The indication for DSC was cardiac dilatation with tamponade-like behavior upon attempted sternal closure in all. In 7 of 10 cases, DSC were possible within 4 days after operation. There were statistical decrease in heart rate (HR), left atrial pressure (LAP), cardiothoracic ratio (CTR) and inspiratory oxygen concentration of the respirator at the time of DSC compared to those in the early postoperative period. None of the patients had mediastinitis or other severe infection in the postoperative course. One patient each died of progressive pulmonary venous obstruction and of non-cardiac disease late postoperatively and 8 patients are long-term survivors. It is concluded that DSC is recommended whenever there is any hemodynamic deterioration due to attempted sternal closure following open heart surgery in infancy as it could be safely performed within 3 to 4 days after operation without any complication.
