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What is the impact of a previously failed Robicsek repair in the subsequent treatment of sternal dehiscence with thermoreactive nitinol clips?
  • Yunus Seyrek,
  • Murat Akkuş
Yunus Seyrek
Istanbul Mehmet Akif Ersoy Training and Research Hospital
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Murat Akkuş
Istanbul Mehmet Akif Ersoy Training and Research Hospital
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Abstract

Background: In this study, we conducted a retrospective review of patients at our institution with noninfectious sternal dehiscence (NISD) after median sternotomy who received thermoreactive nitinol clips (TRNC) treatment during a 10-year period. We compared TRNC patients with and without history of failed Robicsek repair. The purpose of the study was to analyze the impact of previous Robicsek repair on the treatment of sternal dehiscence with TRCN. Methods: Between December 2009 and January 2020, out of 283 patients with NISD who underwent refixation, we studied 34 cases who received TRNC treatment. We divided these 34 cases into two groups: patients who had a previously failed Robicsek procedure before TRNC treatment (group A, n=11) and patients who had been directly referred to TRCN treatment (group B, n= 23). Results: Postoperative complication rate was significantly higher in group A (p=0.026). Hospitalization duration was significantly longer in group A due to the higher complication rate (p=0.001). Operative time was significantly shorter and blood loss was significantly lower in group B (p=0.001). Conclusion: The Robicsek procedure is considered an effective method in the treatment of NISD but, in case of its failure, subsequent TRNC treatment might become cumbersome in high-risk patients. In our study, a previously failed Robicsek procedure caused significantly higher morbidity and additional operative risk in later TRNC treatment of high-risk cases. Ultimately, we speculate that a direct TRNC treatment for NISD is favorable in high-risk patients.

Peer review status:UNDER REVIEW

04 Apr 2021Submitted to Journal of Cardiac Surgery
05 Apr 2021Submission Checks Completed
05 Apr 2021Assigned to Editor
07 Apr 2021Reviewer(s) Assigned
27 Apr 2021Review(s) Completed, Editorial Evaluation Pending
27 Apr 2021Editorial Decision: Revise Major
02 May 20211st Revision Received
04 May 2021Submission Checks Completed
04 May 2021Assigned to Editor
05 May 2021Reviewer(s) Assigned