PMID- 2779044
OWN - NLM
STAT- MEDLINE
DCOM- 19891017
LR  - 20061115
IS  - 0021-5252 (Print)
IS  - 0021-5252 (Linking)
VI  - 42
IP  - 6
DP  - 1989 Jun
TI  - [Report of 108 patients with valvular heart disease who underwent re-operations 
      through repeated median sternotomy incision].
PG  - 426-30, discussion 431-3
AB  - 108 patients who underwent redo median sternotomy between January 1975 and April 
      1988 were studied to determine factors affecting risk of cardiac reoperations. 
      (1) Seventeen of 108 patients died, yielding an overall mortality of 15.7%. (2) 
      Preoperative diagnosis had a significant correlation with mortality, which was 
      higher with prosthetic valve endocarditis (50.0%) than with all other indications 
      for reoperation. (3) Operative mortality was related to pre-reoperation 
      functional class: 8.7% for New York Heart Association (NYHA) class II, 9.8% for 
      class III and 27.8% for class IV. (4) Based on the degree of urgency, elective 
      reoperation had a mortality of 5.4%, while emergency procedures carried a 
      mortality of 61.5%. (5) Cardiac catheterization information was available in 53 
      patients. The pulmonary artery pressure was higher in the died group. There were 
      no significant differences in pulmonary capillary wedge pressure and cardiac 
      index between the survived and died. (6) Operation time, aortic cross clamp time 
      and pump run were significantly longer in the died than in the survived group. 
      The died had more blood loss during operative procedure. To decrease operative 
      mortality, technical improvement and increased experience were necessary for 
      surgeons. We prefer to free entirely pericardial adhesion to facilitate 
      mobilization and evacuate air, and to make intra-cardiac procedure more easier 
      and safety. Furthermore early reoperation before irreversible deterioration 
      occurs was necessary since myocardial function was found to be a major 
      determinant of surgical results.
FAU - Terada, Y
AU  - Terada Y
FAU - Wanibuchi, Y
AU  - Wanibuchi Y
FAU - Takagi, H
AU  - Takagi H
FAU - Shimoyama, Y
AU  - Shimoyama Y
FAU - Ino, T
AU  - Ino T
FAU - Furuta, S
AU  - Furuta S
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Kyobu Geka
JT  - Kyobu geka. The Japanese journal of thoracic surgery
JID - 0413533
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Heart Valve Diseases/mortality/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Reoperation/mortality
MH  - Risk Factors
MH  - Sternum/*surgery
EDAT- 1989/06/01 00:00
MHDA- 1989/06/01 00:01
CRDT- 1989/06/01 00:00
PHST- 1989/06/01 00:00 [pubmed]
PHST- 1989/06/01 00:01 [medline]
PHST- 1989/06/01 00:00 [entrez]
PST - ppublish
SO  - Kyobu Geka. 1989 Jun;42(6):426-30, discussion 431-3.