PMID- 21138917
OWN - NLM
STAT- MEDLINE
DCOM- 20110613
LR  - 20110224
IS  - 1569-9285 (Electronic)
IS  - 1569-9285 (Linking)
VI  - 12
IP  - 3
DP  - 2011 Mar
TI  - Prophylactic sternal plating with pectoralis advancement flaps after sternotomy 
      in patients with a history of chest irradiation.
PG  - 355-8
LID - 10.1510/icvts.2010.247262 [doi]
AB  - Deep sternal infections secondary to bony instability and malunion, can result in 
      mediastinitis. Previous authors have described the use of prophylactic rigid 
      plate fixation in high-risk patients. The purpose of our study is to review the 
      use of prophylactic sternal platting with pectoralis advancement flaps in 
      high-risk patients with a history of chest irradiation. Fourteen patients (July 
      2003-September 2008) with a history of chest irradiation who underwent a median 
      sternotomy followed by prophylactic rigid plate fixation of the sternum were 
      reviewed. Breast cancer was the most common etiology of chest irradiation (n=11, 
      78%). The average EuroSCORE was 24.06% with 72% of patients having a preoperative 
      New York Heart Association (NYHA) class>/=III. There were no episodes of sternal 
      non-union, mediastinitis or death. Follow-up was 100% with a 0% 30-day and a 7.1% 
      one-year mortality rate (non-cardiac). A comparison between mean preoperative 
      left ventricular ejection fraction (LVEF) (49.6%) and postoperative LVEF (59.7%) 
      was statistically significant (P<0.0001). All living patients currently maintain 
      a NYHA class I/II. Prophylactic rigid plate fixation and pectoralis flap coverage 
      decreases the risk of developing sternal dehiscence and postoperative wound 
      complications and should therefore be considered in high-risk patients with a 
      history of chest irradiation.
FAU - Neaman, Keith C
AU  - Neaman KC
AD  - Grand Rapids Medical Education Partners, Michigan State University Plastic 
      Surgery Residency, Grand Rapids, MI, USA.
FAU - Blount, Andrew L
AU  - Blount AL
FAU - Kim, John A
AU  - Kim JA
FAU - Renucci, John D
AU  - Renucci JD
FAU - Hooker, Robert L
AU  - Hooker RL
LA  - eng
PT  - Journal Article
DEP - 20101207
PL  - England
TA  - Interact Cardiovasc Thorac Surg
JT  - Interactive cardiovascular and thoracic surgery
JID - 101158399
SB  - IM
CIN - Interact Cardiovasc Thorac Surg. 2011 Mar;12(3):358-9. PMID: 21345822
MH  - Aged
MH  - *Bone Plates
MH  - *Cardiac Surgical Procedures
MH  - Female
MH  - Humans
MH  - Male
MH  - Mediastinitis/etiology/prevention & control
MH  - Michigan
MH  - Pectoralis Muscles/*surgery
MH  - Radiotherapy/adverse effects
MH  - Sternotomy/adverse effects/*instrumentation/mortality
MH  - *Surgical Flaps/adverse effects
MH  - Surgical Wound Dehiscence/etiology/prevention & control
MH  - Surgical Wound Infection/etiology/prevention & control
MH  - Thoracic Cavity/*radiation effects
MH  - Time Factors
MH  - Treatment Outcome
MH  - Wound Closure Techniques/adverse effects/*instrumentation/mortality
EDAT- 2010/12/09 06:00
MHDA- 2011/06/15 06:00
CRDT- 2010/12/09 06:00
PHST- 2010/12/09 06:00 [entrez]
PHST- 2010/12/09 06:00 [pubmed]
PHST- 2011/06/15 06:00 [medline]
AID - icvts.2010.247262 [pii]
AID - 10.1510/icvts.2010.247262 [doi]
PST - ppublish
SO  - Interact Cardiovasc Thorac Surg. 2011 Mar;12(3):355-8. doi: 
      10.1510/icvts.2010.247262. Epub 2010 Dec 7.