ABSTRACT

Objective:To evaluate the incidence and early outcome of patients who underwent operative strategy of open chest management (OCM) and delayed sternal closure (DSC) after cardiac surgery because of poor hemodynamics.

Methods: It was a prospective observational descriptivestudy which was conducted at Chaudhary Pervaiz Elahi (CPE) Institute of Cardiology, Multan; from September 2017 to July 2020. All patients who underwent open chest management because of poor hemodynamics were included. In-hospital mortality and surgical site infection were primary end-points of the study.

Results:4,750 patients were operated for cardiac diseases, out of which only 22 (0.46%) patients underwent OCM with DSC. The cause of hemodynamic instability was very low cardiac output state (LCOS) in 19 (86.36%) patients, 2 (9.1%) patients had diffuse mediastinal bleeding and 1 (4.54%) patient had recurrent arrhythmias. 10 (45.5%)patients were survived to discharge. In hospital mortality was 12 (54.5%).One patient (4.54%) developed surgical site wound infection.

Keywords: Open chest management, delayed sternal closure, poor hemodynamics