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Archivos de cardiología de México
On-line version ISSN 1665-1731Print version ISSN 1405-9940
Abstract
DILIZ-NAVA, Héctor et al. Safety of repeat median sternotomy in the palliative treatment of patients with a univentricular heart. Arch. Cardiol. Méx. [online]. 2017, vol.87, n.4, pp.302-306. ISSN 1665-1731. https://doi.org/10.1016/j.acmx.2016.10.006.
Objective:
To establish the morbidity and mortality of patients with univentricular hearts who underwent a repeat median sternotomy at the Instituto Nacional de Pediatría.
Method:
A retrospective review was performed on the clinical charts of all patients who under-went a repeat median sternotomy from 2001 to 2016.
Results:
Sixty-five patients underwent 76 surgeries by repeat median sternotomy. Fifty-nine patients had a first repeat median sternotomy, with a mean age of 36 months (range: 4–176 months) and a mean weight of 12.2 kg (range: 3.2–21.5 kg). Forty patients had a Glenn procedure, and 19 patients had a Fontan procedure. There were 17 patients with a second repeat median sternotomy, with a mean age of 89 months (range 48–156 months), and a mean weight of 22.7 kg (14.4–41 kg). A Fontan procedure was performed on all these 17 patients. A section of the right coronary artery with electrocardiographic changes and a right atrium tear that caused hypotension occurred during first repeat sternotomy. An aortic tear occurred during a second repeat sternotomy with massive bleeding and subsequent death. This represents 3.9% of re-entry injuries.
Conclusion:
It is concluded that repeat median sternotomy is a safe procedure.
Keywords : Repeat median sternotomy; Safety; Univentricular heart; Glenn; Fontan; Mexico.