OBJECTIVES We examined whether bilateral internal thoracic artery (BITA) revascularization is associated with any increased in-hospital mortality and complications compared with single internal thoracic artery (SITA) revascularization. BACKGROUND Despite proven long-term benefits, BITA revascularization has been slow to be adopted because of fear of increased early morbidity. METHODS We eva...

OBJECTIVES Deep sternal wound infection is a severe complication after cardiac surgery. Insufficient antibiotic target site concentrations may account for variable success of perioperative prophylaxis. Therefore, we measured perioperative penetration of cefazolin and of linezolid into sternal cancellous bone after sternotomy in coronary artery bypass grafting (CABG) patients by in vivo microdia...

Negative-pressure wound therapy (NPWT) has been used for the treatment of deep sternal wound infection (DSWI) with promising results. However, questions have been raised regarding the potential risk of right ventricle (RV) rupture during treatment. In the present study, we evaluate our clinical experience of NPWT focusing on RV rupture and major bleeding complications and its potentially negati...

a a i r s c p Background. Sternal wound infections are a major omplication after cardiac surgery in terms of morbidity nd cost increase. To decrease the incidence of infection, e evaluated triclosan-coated sutures for the closure of he sternal incision, as it is known that most of the urgical site infections are related to the incision site. Methods. From May to December 2005, a total of 479 at...

Figure 1. Mediastinal defect with exposed pros-thetic aortic root graft. DESCRIPTION A 70-year-old woman with short stature and hypermastia underwent ascending aortic aneurysm repair with a prosthetic graft, complicated by postoperative mediastinitis and sternal dehiscence. She was treated with aggressive sternal debridement and negative pressure wound therapy for 1 week (Fig 1) prior to defini...

BACKGROUND The management of hospital-acquired infections (HAIs) with respect to physician practices remains largely unexplored despite increasing efforts to standardize care. In the present study, we report findings from a 2-month audit of all patients that have undergone cardiac surgery at a large referral center in Atlantic Canada. METHODS All patients who underwent cardiac surgical proced...

OBJECTIVES Early microbiological diagnosis of deep sternal wound infections (DSWI) could improve outcomes by allowing targeted antibiotic treatment. This study aims to analyse the utility of superficial sternal wound swabs and blood cultures. METHODS From January 2005 to June 2011, 70 patients were prospectively identified with DSWI. Microbiological data were obtained retrospectively to study...

OBJECTIVES The aim of this study was to investigate the incidence and predictors of deep sternal wound infection (DSWI) in a contemporary cohort of patients undergoing cardiac surgery. The early and late outcomes of patients with this complication also were analyzed. DESIGN A retrospective study of consecutive patients undergoing cardiac surgery using a computerized database based on the New ...

OBJECTIVES Sternal wound complications following median sternotomy remain a challenge in cardiac surgery. Changes in both patient profile and type of operations have been observed in recent years. Therefore, we analysed current wound healing complications after median sternotomy at our centre. METHODS All adult patients undergoing a median sternotomy between January 2009 and April 2011 were i...