Median Sternotomy for Open Cardiac Surgery During Total Heart-Lung By-Pass

Gerbode, Frank; Braimbridge, M. V.; Melrose, D. G.

doi:10.1001/archsurg.1958.01280230161024

Cited by 27 publications

(10 citation statements)

References 2 publications

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“…Operative Technique.-The heart was exposed through a midline sternal split incision (Gerbode et al, 1958). Elective cardiac arrest has been carried out in all but one case.…”

Section: Materials and Managementmentioning

confidence: 99%

Surgery of Ventricular Septal Defects

Nicks¹,

Cartmill²,

Clifton³

et al. 1962

BMJ

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“…Operative Technique.-The heart was exposed through a midline sternal split incision (Gerbode et al, 1958). Elective cardiac arrest has been carried out in all but one case.…”

Section: Materials and Managementmentioning

confidence: 99%

Surgery of Ventricular Septal Defects

Nicks¹,

Cartmill²,

Clifton³

et al. 1962

BMJ

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“…Other prominent surgeons of the era reinforced the fact that this approach was less traumatic and provided access to all chambers of the heart along with the capability of connecting the patients to cardiopulmonary bypass [8]. Since then, this procedure gained prominence and rapidly became the most common approach to the heart.…”

Section: Introductionmentioning

confidence: 99%

Access to the Heart – Evolution of surgical techniques

Raman¹

2015

Glob Surg

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Access to the heart and closure of the resultant incisions and wounds have been considered major impediments to the growth of cardiac surgery. Nevertheless, during the 1980s and 1990s, the sternotomy was the most commonly performed surgical access procedure in the world. We discuss the evolution of various techniques to allow access to the heart and surrounding structures. Methods of closure of these incisions are also highlighted as these techniques evolve.

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“…Since the introduction of the median sternotomy technique for cardiac surgery in the 1950's and its support by surgeons such as Gerbode et al [1] and Julian et al [2], it has become the standard approach for open access to the anterior mediastinum. Although the wound complications of such operative techniques are relatively small (i.e., wound infections reach up to 2.1% and bony nonunion up to 5.1% of all cases), their consequences are extremely detrimental.…”

Section: Introductionmentioning

confidence: 99%

Open Reduction Internal Fixation Poststernotomy Mediastinitis

Sinno

Dionisopoulos

2013

Plastic Surgery International

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Introduction. Mediastinitis has been reported to complicate 5% of sternotomy surgery. We have adopted an open reduction and rigid internal fixation (ORIF) approach during the conventional rescue surgery in the treatment of mediastinitis. Methods. A retrospective review was performed to compare the outcomes of patients that had an ORIF to correct postoperative mediastinitis following median sternotomy. These were compared with the outcome of the patients that did not undergo ORIF. Results. In the 5-year study period, we reviewed 35 mediastinitis patient charts. Postoperatively, the ORIF patient group remained in the Intensive Care Unit (ICU) and on a ventilator for a mean of 1.5 and 0.75 days, respectively. Patients treated without ORIF spent significantly more days in the ICU (mean of 7.5 days, P < 0.05) and on a ventilator (mean of 2.15 days, P = 0.1). Furthermore, it was found that none of the patients (0%) who underwent ORIF complained of any postoperative sternal instability or pain. Preoperatively, however, these rates were as high as 72%. Conclusions. In the select patient, ORIF can be a safe option in the management of mediastinitis, which we have shown to significantly decrease morbidity and mortality by providing anatomic reduction as well as physiologic stabilization. We have shown that ORIF will improve the quality of life of the patient by minimizing abnormal sternal mobility and pain and will also decrease inpatient costs by decreasing days spent in the ICU and ventilator dependence.

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Median Sternotomy for Open Cardiac Surgery During Total Heart-Lung By-Pass

Cited by 27 publications

References 2 publications

Surgery of Ventricular Septal Defects

Surgery of Ventricular Septal Defects

Access to the Heart – Evolution of surgical techniques

Open Reduction Internal Fixation Poststernotomy Mediastinitis

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