Our Summary

This study looks at the medical records of people who had bleeding from the chest during a repeat surgery on the aorta (the main blood vessel in the body), from May 2018 to August 2021. The surgery was done under general anesthesia and involved placing a tube in the windpipe. If necessary, the team bypassed the heart and lungs by connecting tubes to the femoral artery and vein (in the leg) and to a large vein in the chest called the superior vena cava. If needed, other tubes were positioned for draining the left side of the heart.

In total, 11 patients (mostly men, average age about 44) were part of the study. All surgeries were completed successfully without any complications like strokes or paralysis. Sadly, two patients passed away during their hospital stay and two more passed away after they were discharged, but the rest are doing well.

The study concludes that using a bypass technique that involves the femoral artery and vein, along with cooling the body to slow down circulation (hypothermic circulatory arrest), is a safe and reliable method to control bleeding from the chest during repeat aorta surgeries.

FAQs

  1. What is the method used to handle sternotomy hemorrhage during redo aortic surgery?
  2. What were the outcomes for patients who developed sternotomy hemorrhage during redo aortic surgery between May 2018 and August 2021?
  3. How safe and reliable is the femoral-femoral bypass with hypothermic circulatory arrest technique in cases of sternotomy hemorrhage during redo aortic surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sternotomy is to follow post-operative care instructions carefully, including taking prescribed medications, avoiding strenuous activities, and attending follow-up appointments to monitor healing and prevent complications. It is also important to report any signs of infection, excessive bleeding, or difficulty breathing to your healthcare provider immediately.

Suitable For

Patients who are typically recommended sternotomy include those undergoing redo aortic surgery who develop sternotomy hemorrhage. These patients may require cardiopulmonary bypass and may benefit from femoral artery, vein, and superior vena cava cannulation. The use of hypothermic circulatory arrest may be necessary in these cases to successfully complete the surgery and prevent complications such as cerebrovascular events or paraplegia.

Timeline

Before sternotomy:

  • Patient undergoes preoperative evaluation and preparation for surgery
  • Patient is brought to the operating room and placed under general anesthesia
  • Surgical team performs the sternotomy procedure to access the chest cavity
  • The main surgery or procedure is conducted as planned
  • Patient is monitored closely during the postoperative period for any complications or issues

After sternotomy:

  • Surgical team closes the sternotomy incision
  • Patient is transferred to the recovery room for monitoring and pain management
  • Patient is typically kept in the hospital for a period of time for observation and recovery
  • Patient may experience pain, discomfort, and restricted mobility due to the sternotomy incision
  • Patient undergoes physical therapy and rehabilitation to aid in recovery and regain strength
  • Patient is discharged from the hospital and instructed on postoperative care and follow-up appointments.

What to Ask Your Doctor

  1. What is sternotomy hemorrhage and what causes it during redo aortic surgery?
  2. What are the risks and potential complications associated with sternotomy hemorrhage?
  3. How is sternotomy hemorrhage typically managed during redo aortic surgery?
  4. What is the role of hypothermic circulatory arrest in treating sternotomy hemorrhage?
  5. What are the success rates of using the femoral-femoral bypass with hypothermic circulatory arrest technique in cases of sternotomy hemorrhage?
  6. Are there any alternative treatment options for sternotomy hemorrhage?
  7. What is the recovery process like for patients who have undergone treatment for sternotomy hemorrhage?
  8. How can patients prevent sternotomy hemorrhage during redo aortic surgery?
  9. What are the long-term outcomes for patients who have experienced sternotomy hemorrhage?
  10. Are there any specific post-operative care instructions or precautions for patients who have undergone treatment for sternotomy hemorrhage?

Reference

Authors: Tang T, Wu C, Liu J, Jian K, Liu W, Sheng W. Journal: Braz J Cardiovasc Surg. 2023 Oct 6;38(6):e20220164. doi: 10.21470/1678-9741-2022-0164. PMID: 37801053