Thermoreactive nitinol clips: Propensity score comparison with Robicsek technique

Sarikaya, Sabit; Aksoy, Eray; Özen, Yücel; Dedemoğlu, Mehmet; Özgür, Mustafa; Büyükbayrak, Fuat; Kırali, Kaan

doi:10.1177/0218492314548432

Cited by 8 publications

(9 citation statements)

References 12 publications

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“…The key to the successful management of NISD is early referral to refixation [9]. Time to reoperation for refixation varies in the literature from 10 to 300 days [4,6]. In our study, refixation was performed after a mean time of 49.4±9.5 days following the initial procedure.…”

Section: Discussionmentioning

confidence: 86%

What is the impact of a previously failed Robicsek repair in the subsequent treatment of sternal dehiscence with thermoreactive nitinol clips?

Seyrek

Akkuş

2021

Preprint

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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.

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Section: Discussionmentioning

confidence: 86%

What is the impact of a previously failed Robicsek repair in the subsequent treatment of sternal dehiscence with thermoreactive nitinol clips?

Seyrek

Akkuş

2021

Preprint

View full text Add to dashboard Cite

show abstract

“…The key to the successful management of NISD is early referral to refixation 8 . Time to reoperation for refixation varies in the literature from 10 to 300 days 4,6 . In our study, refixation was performed after a mean time of 49.4 ± 9.5 days following the initial procedure.…”

Section: Discussionmentioning

confidence: 89%

“…8 Time to reoperation for refixation varies in the literature from 10 to 300 days. 4,6 In our study, refixation was performed after a mean time of 49.4 ± 9.5 days following the initial procedure. Surgery for this complication should be performed as soon as possible.…”

Section: Discussionmentioning

confidence: 99%

What is the impact of a previously failed Robicsek repair in the subsequent treatment of sternal dehiscence with thermoreactive nitinol clips?

Seyrek

Akkuş

2021

Journal of Cardiac Surgery

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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. The purpose of the study was to analyze the impact of previous Robicsek repair on the later treatment of sternal dehiscence with TRCN to establish which method was better in high‐risk patients with NISD. 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). High‐risk patients were defined as those having three or more risk factors. Results Postoperative complication rate was significantly higher in group A (p = .026). Hospitalization duration was significantly longer in group A due to the higher complication rate (p = .001). Operative time was significantly shorter and blood loss was significantly lower in group B (p = .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, additional operative risk and lower success rate in later TRNC treatment of high‐risk cases. Ultimately, we speculate that a direct TRNC treatment for NISD is favorable in high‐risk patients.

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“…[1][2][3] There is no consensus on a standard, preferred technique. Sarıkaya et al [12] compared the Robicsek technique and TRNCs. They reported similar complication rates (6.3% for the Robicsek technique and 7.7% for TRNCs).…”

Section: Discussionmentioning

confidence: 99%

Clinical results of nitinol plate implentation for reconstruction of sternal dehiscence

Apaydin¹

2021

South Clin Ist Euras

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Objective: Difficulties with sternal bone healing or infection after a median sternotomy performed for open cardiac surgery can result in significant morbidity and mortality. This study evaluates the efficacy, safety, advantages, disadvantages, and techniques related to the use of thermoreactive nitinol clips (TRNCs) to treat sternal dehiscence.Methods: TRNCs were used to close the sternum in 40 patients (26 male, 14 female; mean age: 60±4 years, range: 45-76 years) with sternal dehiscence that developed following primary cardiac surgery between July 2010 and February 2019. Sternum revision was performed at a mean of 72±4 days postoperative (range: 9-255 days). Vacuum-assisted closure (VAC) was applied before the surgical intervention in 55% (n=22) of the patients due to superficial wound infection.Results: Pleurisy was observed in 1 patient, and pneumonia developed in 1 patient after the revision. Mortality did not occur during hospitalization. The nitinol plates were removed in a second revision surgery in 9 patients: a pectoralis flap was created for 3, a reconstructive rectus flap was used in 1, and primary wound closure was implemented in 5 cases due to recurrent wound infection. Mortality was recorded in 1 patient in the postoperative period. Sternotomy complications of recurrent sternal dehiscence, mediastinitis, sternal abscess, or secondary osteomyelitis were not observed in 6 months of follow-up. Conclusion:Surgical interventions for sternal dehiscence should optimally be performed in the early period to decrease the risk of dehiscence secondary to infection and mediastinitis. The use of TRNCs for patients with sternal dehiscence was successful and decreased the duration of hospital stay and the risk of postoperative complications, as well as providing greater patient comfort.

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Thermoreactive nitinol clips: Propensity score comparison with Robicsek technique

Cited by 8 publications

References 12 publications

What is the impact of a previously failed Robicsek repair in the subsequent treatment of sternal dehiscence with thermoreactive nitinol clips?

What is the impact of a previously failed Robicsek repair in the subsequent treatment of sternal dehiscence with thermoreactive nitinol clips?

What is the impact of a previously failed Robicsek repair in the subsequent treatment of sternal dehiscence with thermoreactive nitinol clips?

Clinical results of nitinol plate implentation for reconstruction of sternal dehiscence

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