Reconstrução da parede torácica com suporte metálico externo: técnica alternativa na mediastinite pós-esternotomia

Nina, Vinicius José da Silva; Assef, Marco Aurélio Salles; Rodrigues, Raimundo Reis; Mendes, Vinícius Giuliano Gonçalves; Lages, Joyce Santos; Amorim, Ângela Mirella Magalhães; Filho, Natalino Salgado; Nina, Rachel Vilela de Abreu Haickel

doi:10.1590/s0102-76382008000400009

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…Mediastinitis is a deep wound infection after median sternotomy, with clinical evidence and / or microbiological commitment of the retrosternal space, associated with sternal osteomyelitis with or without its instability [1][2][3][4]. It is one of the most serious complications of median sternotomy and is associated to significant morbidity and mortality [5].…”

Section: Introductionmentioning

confidence: 99%

Skeletonized left internal thoracic artery is associated with lower rates of mediastinitis in diabetic patients

Sá¹,

Soares²,

Santos³

et al. 2011

Rev Bras Cir Cardiovasc

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Background: Mediastinitis is a serious complication of median sternotomy and is associated to significant morbidity and mortality. Diabetes is a feared risk factor for mediastinitis and viewed with caution by cardiovascular surgeons.Objective SÁ, MPBO ET AL -Skeletonized left internal thoracic artery is associated with lower rates of mediastinitis in diabetic patientsRev Bras Cir Cardiovasc 2011;26(2):183-9

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Section: Introductionmentioning

confidence: 99%

Skeletonized left internal thoracic artery is associated with lower rates of mediastinitis in diabetic patients

Sá¹,

Soares²,

Santos³

et al. 2011

Rev Bras Cir Cardiovasc

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“…The use of prostheses and orthoses have become necessary to the development of cardiovascular surgery, since the correction of complex congenital heart disease and valvular heart disease require the use of these materials as vascular substitutes [1]. Carpentier et al [2], with the introduction of glutaraldehyde at low concentration for the preservation of biological tissues, started a new period by introducing the concept of bioprosthesis, which despite being a biological tissue, it loses its antigenicity, does not induce the formation of antibodies and produces the disruption of intra and intermolecular protein, enhancing its structural stability, decreasing its antigenicity and maintaining the sterile tissue.…”

Section: Introductionmentioning

confidence: 99%

Bovine pericardium retail preserved in glutaraldehyde and used as a vascular patch

et al. 2011

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BackgroundIn this study we evaluated the performance of bovine pericardium preserved in glutaraldehyde used as a vascular patch.MethodsFourteen young pigs, six females and eight males, weighting 10.3 - 18.4 kg were used in our study. We implanted three remnants in each pig, two in the abdominal aorta and one was juxtaposed to the peritoneum. The smooth face (SF) and rough face (RF) of each remnant were implanted turned to the vessel inner portion and one remnant was juxtaposed to the peritoneum. The animals were sacrificed in 4.5 - 8 months after surgery (75 - 109 kg). The remnants were assessed for aorta wall, fibroses formation in inner apposition and calcification related to the face turned to the vessel inner portion.ResultsThe rough face showed a lower dilatation level compared to the face implanted in adjacent aorta. There was no difference between intensity and/or incidence of graft calcification when the superficies were compared. The bovine pericardium preserved in glutaraldehyde did not show alterations in its structure when implanted with different faces turned to the inner portion of vessel.ConclusionWhen turned to the inner portion of the vessel, the rough face of the remnant presented a lower dilatation in relation to the adjacent aorta and a better quality of endothelium layer and did not show a difference between intensity and/or incidence of graft calcification.

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Section: Introductionmentioning

confidence: 99%

Artéria torácica interna esqueletizada está associada a menores taxas de mediastinite em idosos submetidos à cirurgia de revascularização miocárdica

Sá¹,

Santos²,

Figueiredo³

et al. 2011

Rev Bras Cir Cardiovasc

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Artéria torácica interna esqueletizada está associada a menores taxas de mediastinite em idosos submetidos à cirurgia de revascularização miocárdicaSkeletonized internal thoracic artery is associated with lower rates of mediastinitis in elderly undergoing coronary artery bypass grafting surgery Abstract Background and Objectives: Mediastinitis is a serious complication of median sternotomy and is associated to significant morbidity and mortality. The aim of this study is to identify which option of harvesting internal thoracic artery (ITA), pedicled or skeletonized, is associated with lower rates of mediastinitis after coronary artery bypass grafting surgery (CABG) in elderly, in the Division of Cardiovascular Surgery of PROCAPE.Methods: Retrospective study of 160 elderly who underwent consecutive CABG between May 2007 and June 2011. Eleven preoperative variables, four intraoperative variables and eight postoperative variables possibly involved in the development of postoperative mediastinitis were evaluated between two groups: CABG with skeletonized ITA (n=80) and pedicled ITA (n=80). Univariate and multivariate logistic regression analyses were applied.Results: The incidence of mediastinitis was 6.8% (n=11), with a lethality rate of 54.5% (n=6). The skeletonized ITA group were more exposed than pedicled ITA group to obesity (n=12 vs. n=4; 15% vs. 5%; P=0.035) and multiple transfusions (n=25 vs. n=11; 31.2% vs. 13.7%; P=0.008). The pedicled ITA group presented a greater risk of mediastinitis after CABG than skeletonized ITA group (n=10 vs. n=1; 12.5% vs. 1.2%; Unadjusted OR 11.3; 95% CI 1.4 -241.5; P=0.008). In multivariate analysis, this difference maintained statistically significant (Adjusted OR 5.2; 95% CI 1.5-495.8; P=0.012), being considered an independent association.Conclusions: We suggest that elderly should be considered for strategies to minimize risk of infection. In elderly that undergo unilateral ITA, the problem seems to be related to how ITA is harvested. Elderly should always be considered for use of skeletonized ITA. 618Sá MPBO, et al. -Skeletonized internal thoracic artery is associated with lower rates of mediastinitis in elderly undergoing coronary artery bypass grafting surgery Bras Cir Cardiovasc 2011;26(4):617-23 Rev

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Reconstrução da parede torácica com suporte metálico externo: técnica alternativa na mediastinite pós-esternotomia

Abstract: The reconstruction of the chest wall utilizing temporary metal braces showed to be a safe and effective procedure with good aesthetic and functional outcomes in this group of patients.

Cited by 5 publications

References 14 publications

Skeletonized left internal thoracic artery is associated with lower rates of mediastinitis in diabetic patients

Skeletonized left internal thoracic artery is associated with lower rates of mediastinitis in diabetic patients

Bovine pericardium retail preserved in glutaraldehyde and used as a vascular patch

Artéria torácica interna esqueletizada está associada a menores taxas de mediastinite em idosos submetidos à cirurgia de revascularização miocárdica

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