İhsan Peker1, Orhan Gökalp2, Yüksel Beşir2, Levent Yılık2, Hasan İner2, Nihan Yeşilkaya2, Şahin İşcan1, Ali Gürbüz2
1Department of Cardiovascular Surgery, Izmir Katip Çelebi University Atatürk Training and Research Hospital, Izmir, Turkey
2Department of Cardiovascular Surgery, Izmir Katip Çelebi University, Faculty of Medicine, Izmir, Turkey
Keywords: Cardiopulmonary bypass, redo open heart surgery, resternotomy
Objectives: In this study, we aimed to investigate the effect of the initiation of cardiopulmonary bypass (CPB) before sternotomy on the postoperative outcomes in patients undergoing redo open heart surgery.
Patients and methods: A total of 104 patients (58 males, 46 females; mean age 48.2 years; range, 13 to 77 years) who underwent CPB via femoral cannulation before and after sternotomy between January 1990 and December 2016 were retrospectively analyzed. The patients were divided into two groups as those with femoral cannulation before sternotomy (Group 1, n=34) and those with sternotomy without femoral cannulation (Group 2, n=70). Both groups were compared in terms of pre-, intra-, and postoperative data.
Results: There was no significant difference in the pre- and intraoperative results between the groups. The rates of 24-h drainage, extubation time, length of intensive care unit and hospital stay, surgical revision for bleeding, the amount of blood transfusion, prolonged use of inotropic agents, and postoperative acute renal failure were significantly higher in Group 1.
Conclusion: Due to the lack of a significant difference in the pre- and intraoperative data of the patients and the absence of a positive
contribution to the outcome of CPB before sternotomy, it is more reasonable to use this method in only high-risk patients for cardiac injury.