Vermeidung von Komplikationen bei der Resternotomie
Tóm tắt
Bis zu 10 % aller herzchirurgischen Eingriffe sind Reoperationen. Meist erfolgen diese über eine erneute mediane Sternotomie. Dabei besteht die Gefahr der Verletzungen des Herzens, der großen Gefäße und offener Bypass-Grafts. Dies hat erheblichen Einfluss auf Morbidität und Mortalität. Darstellung von Strategien zur Vermeidung von Blutungskomplikationen während der medianen Resternotomie. Recherche und Bewertung zur Evidenz von Präventionsstrategien, Diskussion des eigenen Konzepts. Bei einer Reoperation über eine erneute Sternotomie muss mit Verletzungen der substernalen Strukturen gerechnet werden. Die Kenntnis der retrosternalen anatomischen Verhältnisse, z. B. mithilfe des CT, unterstützt dabei, eine situationsgerechte Strategie zur Vermeidung von Blutungskomplikationen sowie der damit einhergehenden Morbidität und Mortalität zu entwickeln.
Tài liệu tham khảo
IQTIG IQTIG. https://iqtig.org/qs-berichte/qualitaetsreport/2018
Morales DL, Zafar F, Arrington KA et al (2008) Repeat sternotomy in congenital heart surgery: no longer a risk factor. Ann Thorac Surg 86:897–902 (discussion 897–902)
Dobell AR, Jain AK (1984) Catastrophic hemorrhage during redo sternotomy. Ann Thorac Surg 37:273–278
Loop FD (1984) Catastrophic hemorrhage during sternal reentry. Ann Thorac Surg 37:271–272
von Segesser L, Jornod N, Faidutti B (1987) Repeat sternotomy after reconstruction of the pericardial sac with glutaraldehyde-preserved equine pericardium. J Thorac Cardiovasc Surg 93:616–619
Park CB, Suri RM, Burkhart HM et al (2010) Identifying patients at particular risk of injury during repeat sternotomy: analysis of 2555 cardiac reoperations. J Thorac Cardiovasc Surg 140:1028–1035
O’Brien MF, Harrocks S, Clarke A, Garlick B, Barnett AG (2002) How to do safe sternal reentry and the risk factors of redo cardiac surgery: a 21-year review with zero major cardiac injury. J Card Surg 17:4–13
Wiseman DM (1997) Hazards and prevention of postsurgical pericardial adhesions. In: Treutner K, Schumpelick V (Hrsg) Peritoneal adhesions. Springer, Berlin, Heidelberg, S 240–254
Porter JM, Ball AP, Silver D (1971) Mesothelial fibrinolysis. J Thorac Cardiovasc Surg 62:725–730
Cliff WJ, Grobety J, Ryan GB (1973) Postoperative pericardial adhesions. The role of mild serosal injury and spilled blood. J Thorac Cardiovasc Surg 65:744–750
Holman WL, Bourge RC, Zorn GL, Brantley LH, Kirklin JK (1993) Use of expanded polytetrafluoroethylene pericardial substitute with ventricular assist devices. Ann Thorac Surg 55:181–183
Borst HG (1987) Dire consequences of the indiscriminate use of Teflon felt pledgets. J Thorac Cardiovasc Surg 94:442–443
McHenry MC, Longworth DL, Rehm SJ et al (1988) Infections of the cardiac suture line after left ventricular surgery. Am J Med 85:292–300
Vincent JG, Skotnicki SH, van der Meer JJ, Kubat K (1987) Resorbable suture support for ventricular aneurysmectomy. J Thorac Cardiovasc Surg 94:430–433
Cunningham JN Jr., Spencer FC, Zeff R, Williams CD, Cukingnan R, Mullin M (1975) Influence of primary closure of the pericardium after open-heart surgery on the frequency of tamponade, postcardiotomy syndrome, and pulmonary complications. J Thorac Cardiovasc Surg 70:119–125
Nandi P, Leung JS, Cheung KL (1976) Closure of pericardium after open heart surgery. A way to prevent postoperative cardiac tamponade. Br Heart J 38:1319–1323
Milgalter E, Uretzky G, Siberman S et al (1985) Pericardial meshing: an effective method for prevention of pericardial adhesions and epicardial reaction after cardiac operations. J Thorac Cardiovasc Surg 90:281–286
Canver CC, Marrin CA, Plume SK, Nugent WC (1993) Autologous pericardial flap for prevention of reentry injury in cardiac reoperations. Ann Thorac Surg 55:179–180
Nugent WC, Maislen EL, O’Connor GT, Marrin CA, Plume SK (1988) Pericardial flap prevents sternal wound complications. Arch Surg 123:636–639
Harada Y, Imai Y, Kurosawa H, Hoshino S, Nakano K (1988) Long-term results of the clinical use of an expanded polytetrafluoroethylene surgical membrane as a pericardial substitute. J Thorac Cardiovasc Surg 96:811–815
Roselli EE, Pettersson GB, Blackstone EH et al (2008) Adverse events during reoperative cardiac surgery: frequency, characterization, and rescue. J Thorac Cardiovasc Surg 135:316–323
Aviram G, Sharony R, Kramer A et al (2005) Modification of surgical planning based on cardiac multidetector computed tomography in reoperative heart surgery. Ann Thorac Surg 79:589–595
Kamdar AR, Meadows TA, Roselli EE et al (2008) Multidetector computed tomographic angiography in planning of reoperative cardiothoracic surgery. Ann Thorac Surg 85:1239–1245
Morishita K, Kawaharada N, Fukada J et al (2003) Three or more median sternotomies for patients with valve disease: role of computed tomography. Ann Thorac Surg 75:1476–1480 (discussion 1481)
Gandjbakhch I, Acar C, Cabrol C (1989) Left thoracotomy approach for coronary artery bypass grafting in patients with pericardial adhesions. Ann Thorac Surg 48:871–873
Garrett HE Jr., Matthews J (1989) Reoperative median sternotomy. Ann Thorac Surg 48:305