https://doi.org/10.4081/pmc.2024.328
Outcomes of delayed chest closure after congenital heart surgery in neonates
Submitted: 7 August 2023
Accepted: 8 February 2024
Published: 22 February 2024
Accepted: 8 February 2024
Abstract Views: 1384
PDF: 261
HTML: 16
HTML: 16
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
We present the outcomes of delayed chest closure in neonates who underwent congenital heart surgery under cardiopulmonary bypass. Eighty-one consecutive neonatal patients (age ≤ 28 days) with congenital heart diseases who underwent heart operations and after surgery, chest remained open in the intensive care unit until DCC. Correction of transposition of the great arteries pathology was the most common surgical procedure (48.1% of patients). Median sternal closure time from surgery was 3 (2-4) days. Median age of neonates was 9 (5-12) days. In addition, in 4 cases (4.9%) there was secretion from the surgical site after DCC and after taking cultures, in 2 (2.4%) of the cases a pathogen was identified. Multivariable linear regression analysis (adjusted to gender and CPB) showed that only the age-predicted the sternum closure time (β=-0.09, 95%CI: - 0.16 to -0.02, p=0.02). In-hospital mortality was 6 (7.4%) patients. Although the DCC in neonates who underwent CHD surgical correction was related to a high mortality rate, only the age of neonates predicted the sternum closure time in the ICU.
Gangahar DM, McGough EC, Synhorst D. Secondary sternal closure: a method of preventing cardiac compression. Ann Thorac Surg 1981;31:281-2.
DOI: https://doi.org/10.1016/S0003-4975(10)60944-7
Tabbutt S, Duncan BW, McLaughlin D, et al. Delayed sternal closure after cardiac operations in a pediatric population. J Thorac Cardiovasc Surg 1997;113:886-93.
DOI: https://doi.org/10.1016/S0022-5223(97)70261-7
McElhinney DB, Reddy VM, Parry AJ, et al. Management and outcomes of delayed sternal closure after cardiac surgery in neonates and infants. Crit Care Med 2000;28:1180-4.
DOI: https://doi.org/10.1097/00003246-200004000-00044
Jogi P, Werner O. Hemodynamic effects of sternum closure after open-heart surgery in infants and children. Scand J Thorac Cardiovasc Surg 1985;19:217 20.
DOI: https://doi.org/10.3109/14017438509102722
Kumar SR, Scott N, Wells WJ, Starnes VA. Liberal use of delayed sternal closure in children is not associated with increased morbidity. Ann Thorac Surg 2018;106:581-6.
DOI: https://doi.org/10.1016/j.athoracsur.2018.03.053
Das S, Rubio A, Simsic JM, et al. Bloodstream infections increased after delayed sternal closure: cause or coincidence. Ann Thorac Surg 2011;91:793-7.
DOI: https://doi.org/10.1016/j.athoracsur.2010.09.055
Johnson JN, Jaggers J, Li S, et al. Center variation and outcomes associated with delayed sternal closure after stage 1 palliation for hypoplastic left heart syndrome. J Thorac Cardiovasc Surg 2010;139:1205-10.
DOI: https://doi.org/10.1016/j.jtcvs.2009.11.029
Shin HJ, Jhang WK, Park JJ, Yun TJ. Impact of delayed sternal closure on postoperative infection or wound dehiscence in patients with congenital heart disease. Ann Thorac Surg 2011;92:705-9.
DOI: https://doi.org/10.1016/j.athoracsur.2011.03.040
Adler AL, Smith J, Permut LC, et al. Significance of positive mediastinal cultures in pediatric cardiovascular surgical procedure patients undergoing delayed sternal closure. Ann Thorac Surg 2014;98:685-90.
DOI: https://doi.org/10.1016/j.athoracsur.2014.03.038
Özker E, Saritaş B, Vuran C, et al. Delayed sternal closure after pediatric cardiac operations; single center experience: a retrospective study. J Cardiothorac Surg 2012;7:102.
DOI: https://doi.org/10.1186/1749-8090-7-102
Harder EE, Gaies MG, Yu S, et al. Risk factors for surgical site infection in pediatric cardiac surgery patients undergoing delayed sternal closure. J Thorac Cardiovasc Surg 2013;146:326-12.
DOI: https://doi.org/10.1016/j.jtcvs.2012.09.062
Woodward CS, Son M, Calhoon J, et al. Sternal wound infections in pediatric congenital cardiac surgery: a survey of incidence and preventative practice. Ann Thorac Surg 2011;91:799-804.
DOI: https://doi.org/10.1016/j.athoracsur.2010.10.030
Gielchinsky I, Parsonnet V, Krishnan B, et al. Delayed sternal closure following open-heart operation. Ann Thorac Surg 1981;32:273–7.
DOI: https://doi.org/10.1016/S0003-4975(10)61050-8
Anderson CA, Filsoufi F, Aklog L, et al. Liberal use of delayed sternal closure for postcardiotomy hemodynamic instability. Ann Thorac Surg 2002;73:1484-8.
DOI: https://doi.org/10.1016/S0003-4975(01)03601-3
Boeken U, Assmann A, Mehdiani A, et al. Open chest management after cardiac operations: outcome and timing of delayed sternal closure. Eur J Cardiothorac Surg 2011;40:1146-50.
DOI: https://doi.org/10.1016/j.ejcts.2011.02.047
Erek E, Yalcinbas YK, Turkekul Y, et al. Indications and risks of delayed sternal closure after open heart surgery in neonates and early infants. World J Pediatr Congenital Heart Surg 2012;3:229-35.
DOI: https://doi.org/10.1177/2150135111432771
How to Cite
Kanakis, M., Samanidis, G., Kolovou, K., Katsaridis , S., Sait, A. M., Kourelis, G., … Bobos, D. (2024). Outcomes of delayed chest closure after congenital heart surgery in neonates. La Pediatria Medica E Chirurgica, 46(1). https://doi.org/10.4081/pmc.2024.328
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Sara Ugolini, Lorenzo Tofani, Elisa Zolpi, Louise Montalva, Cosimo Lotti, Antonino Morabito, Fabio Chiarenza, Arnaud Bonnard, Morbidity related to major lung thoracoscopic resections in children , La Pediatria Medica e Chirurgica: Vol. 46 No. 2 (2024)
- Sara Ugolini, Chiara Oreglio, Karl Christian Walsh, Antonino Morabito, Follow-up study of three cases of congenital microgastria , La Pediatria Medica e Chirurgica: Vol. 45 No. 2 (2023)
- Cosimo Bleve, Valeria Bucci, Maria Luisa Conighi, Francesco Battaglino, Lorenzo Costa, Lorella Fasoli, Elisa Zolpi, Salvatore Fabio Chiarenza, Horseshoe kidney and uretero-pelvic-junction obstruction in a pediatric patient. Laparoscopic vascular hitch: A valid alternative to dismembered pyeloplasty? , La Pediatria Medica e Chirurgica: Vol. 39 No. 4 (2017)
- Maria Enrica Miscia, Maria Castellano, Stella Chiarini, Giuseppe Lauriti, Marco Casaccia, Pierluigi Lelli Chiesa, Gabriele Lisi, Pediatric primary spontaneous pneumothorax: a comparison of treatment at pediatric surgery vs. thoracic surgery departments , La Pediatria Medica e Chirurgica: Vol. 45 No. 1 (2023)
- E. Callus, E. Quadri, A. Compare, A. Tovo, A. Giamberti, M. Chessa, Life Experiences and Coping Strategies in Adults with Congenital Heart Disease , La Pediatria Medica e Chirurgica: Vol. 35 No. 5 (2013)
- Alessandro Porta, Adriana Avanzini, Marta Bellini, Rosa Maria Crossignani, Stefano Fiocchi, Stefano Martinelli, Luciana Parola, Neonatal gastrointestinal involvement and congenital cytomegalovirus , La Pediatria Medica e Chirurgica: Vol. 38 No. 3 (2016)
- Andrea Zangari, Carmine Noviello, Camilla Todesco, Mercedes Romano, Letizia Trotta, Carmine Botta, Ilaria Cascone, Salvatore Scommegna, Gabriele Vasta, Vito Briganti, Alfonso Papparella, Satisfaction and results of the subareolar incision as treatment for gynecomastia in adolescents: experience of two centers , La Pediatria Medica e Chirurgica: Vol. 46 No. 2 (2024)
- Salvatore Fabio Chiarenza, Maria Luisa Conighi, Andrea Conforti, Ciro Esposito, Maria Escolino, Fabio Beretta, Maurizio Cheli, Vincenzo Di Benedetto, Maria Grazia Scuderi, Giovanni Casadio, Maurizio Marzaro, Leon Francesco Fascetti, Claudio Vella, Cosimo Bleve, Daniela Codric, Paolo Caione, Pietro Bagolan, Guidelines of the Italian Society of Videosurgery in Infancy for the minimally invasive treatment of the esophageal atresia , La Pediatria Medica e Chirurgica: Vol. 39 No. 3 (2017)
- Marta Peretti, Arianna Mariotto, Gabriella Scirè, Elisa Pani, Silvia Zambaldo, Sanzio Bianchi, Francesco Saverio Camoglio, Luca Giacomello, Wandering spleen with a ten-time twisted vascular pedicle , La Pediatria Medica e Chirurgica: Vol. 38 No. 3 (2016)
- Salvatore Fabio Chiarenza, Cosimo Bleve, Ciro Esposito, Maria Escolino, Fabio Beretta, Maurizio Cheli, Vincenzo Di Benedetto, Maria Grazia Scuderi, Giovanni Casadio, Maurizio Marzaro, Leon Francesco Fascetti, Pietro Bagolan, Claudio Vella, Maria Luisa Conighi, Daniela Codric, Simona Nappo, Paolo Caione, Guidelines of the Italian Society of Videosurgery in Infancy for the minimally invasive treatment of the ureteropelvic-junction obstruction , La Pediatria Medica e Chirurgica: Vol. 39 No. 3 (2017)
You may also start an advanced similarity search for this article.