Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지

Delayed Sternal Closure after CABG Using DCP Wide Plate -A Case Report

개심술 후 Plate를 이용한 지연성 흉골 봉합 1예 보고

  • Park, Seung-Il (Dept.of Yhoracic and Cardiovascular Surgery, Yonsei University Wonju College of Medicine) ;
  • Jo, Jae-Min (Dept.of Yhoracic and Cardiovascular Surgery, Yonsei University Wonju College of Medicine) ;
  • Lee, Jong-Guk
  • 박승일 (연세대학교 원주의과대학 흉부외과학교실) ;
  • 조재민 (연세대학교 원주의과대학 흉부외과학교실) ;
  • 이종국
  • Published : 1996.12.01
Download PDF
⟨ Previous Next ⟩

Abstract

Severe hemodynamic dysfunction may follow after the closure of the median sternotomy in patients with myocardial edema, cardiac dilatation, and severe postoperative bleeding. In extreme cases, myocardial edema may be so severe that cardiac function is compromised merely by the edges of the open sternum touching the heart. Sternotomy remained open and delayed sternal closure is already described adjunct in complicated cardiac operations. We experi nced a case of delayed sternal closure after 16 hours of CABG using synthes DCP wide plate in a 54-year old obese female patient. Our experience conims that delayed sternal closure Is an effective at simple means of dealing with severe myocardial edema so we report this case with literature review.

심장수술후 심근의 부종, 심근이완, 심한 술후 출혈 등이 동반된 환자에서는 흉골봉합에 의해 심한 혈역학적 장애가 발생된다. 심한 심부종으로 흉골 봉합시 흉골 일부분에 의한 심압박에도 혈혁학적 장애를 일으키는 경우도 있다. 본 교실에서는 54세의 비만 여성에서 관상동맥 우회술후 Synthes DCP wide plate를 이용한지 연성 흉골 봉합을 경험하였으며, 이러한 지연성 흉골봉합이 심부종이 심한 환자에서는 상당히 효과적이고 간단한 방법임을 확인하였다. 관상동맥 우회술후 16시간만에 성공적으로 지연성 흉골봉합을 경칩하여 좋은 성적을 얻었기에 보고 하고자 한다.

Keywords

References

  1. Ann Thorac Surg v.44 Delayed sternal closure after cardiac surgery Fanning,W.J.;Vasko,J.S.;Kilman,J.W.
  2. J Cardiac Surg v.10 Advantages of delayed sternal closure in cardiac-compromised adult patients Donatelli,F.;Triggiani,M.;Benussi,S.;Grossi,A.
  3. J Thorac Cardiovasc Surg v.91 Delayed sternal closure Josa,m.;Khuri,S.F.;Braunwald,N.S.(et al.)
  4. Ann Thorac Surg v.54 Prolonged open sternotomy and Delayed sternal closure after Cardiac Surgery Furnary,A.P.;Magovern,J.A.;Simpson,K.A.;Magovern,G.J.
  5. 대흉외지 v.28 신생아 개심술 후 지연 흉골봉합 성시찬;이용훈;조은희;전희재;최필조;우종수
  6. J Thorac Cardiovasc Surg v.107 Delayed sternal closure after neonatal cardiac operations HaKimi,M.;Walters,IIIH.L.;Pinsky,W.W.;Gallagher,M.J.;Lyons,J.M.
  7. 대흉외지 v.15 미연성 흉골봉합 치험 1례 안병희;이동준
  8. Ann Thorac Surg v.58 Technique to stent the open sternum after cardiac operations Jones,S.D.;Fullertion,D.A.;Campbell,D.N.(et al.)