Our Summary

This research paper discusses the potential benefits of using a preoperative computerized tomography (CT) scan for patients requiring a second heart surgery. The study analyzed previous research and found that while the CT scan did not significantly reduce the risk of death, injury during surgery, kidney failure or the time of blood supply stoppage, it did significantly reduce the risk of stroke and other major complications. Therefore, the researchers suggest using preoperative CT scans to help decrease the risk of complications during repeated heart surgeries.

FAQs

  1. What is the main benefit of using a preoperative CT scan for patients requiring a second heart surgery according to the research?
  2. Does a preoperative CT scan reduce the risk of death, injury during surgery, kidney failure, or the time of blood supply stoppage?
  3. How can a preoperative CT scan help in decreasing the risk of complications during repeated heart surgeries?

Doctor’s Tip

A doctor may advise a patient undergoing sternotomy to carefully follow post-operative care instructions, including avoiding heavy lifting and strenuous activities for a certain period of time to allow the sternum to properly heal. It is also important for the patient to attend all follow-up appointments and report any unusual symptoms or concerns to their healthcare provider promptly.

Suitable For

Patients who are recommended sternotomy are typically those who require a second heart surgery. These patients may have already undergone a previous heart surgery and are in need of a repeat procedure due to various reasons such as valve dysfunction, coronary artery disease, or other cardiac conditions. Patients who have had a previous sternotomy may have scar tissue and adhesions present in the chest cavity, making the surgery more complex and increasing the risk of complications.

Additionally, patients who have a history of other medical conditions such as obesity, diabetes, hypertension, or chronic kidney disease may also be recommended sternotomy. These patients may have a higher risk of complications during surgery and may benefit from additional imaging studies such as a preoperative CT scan to help assess the anatomy of the chest cavity and plan for the procedure accordingly.

Overall, patients who are recommended sternotomy are those who have a higher risk of complications during surgery due to their medical history, previous surgeries, or underlying health conditions. Using preoperative imaging studies such as CT scans can help to better assess the patient’s anatomy and reduce the risk of complications during repeated heart surgeries.

Timeline

Before sternotomy:

  1. Patient undergoes preoperative assessments, including medical history review, physical examination, and diagnostic tests.
  2. Patient may undergo a preoperative CT scan to assess the heart and surrounding structures.
  3. Surgical team develops a surgical plan based on the CT scan results and other preoperative assessments.

After sternotomy:

  1. Patient is taken to the operating room and placed under general anesthesia.
  2. Surgeon makes an incision in the chest and performs sternotomy to access the heart.
  3. Surgery is performed, which may involve procedures such as coronary artery bypass grafting or valve replacement.
  4. After surgery, patient is monitored in the intensive care unit for a period of time.
  5. Patient undergoes postoperative care, including pain management, physical therapy, and monitoring for complications.
  6. Patient is discharged from the hospital and continues recovery at home, with follow-up appointments scheduled as needed.

What to Ask Your Doctor

  1. What is sternotomy and why is it necessary for my heart surgery?
  2. What are the potential risks and complications associated with sternotomy?
  3. How will the preoperative CT scan help in reducing the risk of complications during a second heart surgery?
  4. Are there any alternative methods or approaches that can be used instead of sternotomy?
  5. How long is the recovery time typically after a sternotomy procedure?
  6. How often do complications occur during or after a sternotomy procedure?
  7. What can I do to prepare for a sternotomy procedure and minimize the risk of complications?
  8. How will the medical team monitor and manage any potential complications that may arise during or after the surgery?
  9. What is the success rate of sternotomy procedures for patients undergoing a second heart surgery?
  10. Are there any long-term effects or considerations I should be aware of after undergoing sternotomy?

Reference

Authors: Kirmani BH, Brazier A, Sriskandarajah S, Azzam R, Keenan DJ. Journal: Interact Cardiovasc Thorac Surg. 2016 Apr;22(4):472-9. doi: 10.1093/icvts/ivv367. Epub 2016 Jan 5. PMID: 26740589