Subxiphoid Incisional Hernia Development after Coronary Artery Bypass Grafting.
10.5090/kjtcs.2012.45.3.161
- Author:
Hye Seon KIM
1
;
Ki Bong KIM
;
Ho Young HWANG
;
Hyung Woo CHANG
;
Kyu Joo PARK
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Korea. kimkb@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Hernia;
Coronary artery bypass;
Sternotomy
- MeSH:
Abdominal Wall;
Body Surface Area;
Cardiac Output, Low;
Coronary Artery Bypass;
Coronary Vessels;
Female;
Follow-Up Studies;
Freedom;
Hemorrhage;
Hernia;
Herniorrhaphy;
Humans;
Risk Factors;
Sternotomy
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2012;45(3):161-165
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Median sternotomy can weaken the upper abdominal wall and result in subxiphoid incisional hernia. We evaluated risk factors associated with the development of subxiphoid incisional hernias after coronary artery bypass grafting (CABG). MATERIALS AND METHODS: Of 1,656 isolated CABGs performed between January 2001 and July 2010, 1,599 patients who were completely followed up were analyzed. The mean follow-up duration was 49.5+/-34.3 months. Subxiphoid incisional hernia requiring surgical repair developed in 13 patients (0.8%). The hernia was diagnosed 16.3+/-10.3 months postoperatively, and hernia repair was performed 25.0+/-26.1 months after the initial operation. Risk factors associated with the development of subxiphoid incisional hernia were analyzed with the Cox proportional hazard model. RESULTS: Five-year freedom from the hernia was 99.0%. Univariate analysis revealed that female sex (p=0.019), height (p=0.019), body surface area (p=0.046), redo operation (p=0.012), off-pump CABG (p=0.049), a postoperative wound problem (p=0.041), postoperative bleeding (p=0.046), and low cardiac output syndrome (p<0.001) were risk factors for the development of the hernia. Multivariable analysis showed that female sex (p=0.01) and low cardiac output syndrome (p<0.001) were associated with subxiphoid hernia formation. CONCLUSION: Female sex and postoperative low cardiac output syndrome were risk factors of subxiphoid hernia. Therefore, special attention is needed for patients with high-risk factors.
