Thorac Cardiovasc Surg 2006; 54(2): 108-111
DOI: 10.1055/s-2005-872864
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Early Detection of Sternal Dehiscence by Conventional Chest X‐Ray

A. A. Peivandi1 , N. Vogel2 , U. T. Opfermann3 , J. Singelmann1 , W. Kuroczynski1 , K. F. Kreitner2 , M. Dahm1 , C. F. Vahl1
  • 1Department of Cardiothoracic and Vascular Surgery, Johannes Gutenberg University Hospital, Mainz, Germany
  • 2Department of Radiology, Johannes Gutenberg University Hospital, Mainz, Germany
  • 3Department of Cardiac Surgery, University of Leipzig, Leipzig, Germany
Weitere Informationen

Publikationsverlauf

Received May 1, 2005

Publikationsdatum:
15. März 2006 (online)

Abstract

Background: Diagnosis of sternal dehiscence after sternotomy for cardiac surgery is still made clinically. The aim of this study was to identify radiographic signs of sternal dehiscence by routine chest X‐ray (CXR) in patients with and without clinically diagnosed sternal dehiscence. Methods: 75 patients (group I: 65 ± 9.3 years, f/m = 12/63) with clinically diagnosed sternal dehiscence, necessitating surgical revision and 75 patients with uneventful sternal healing (matched to group I by age, sex, preoperative risk factors and surgical procedures; group II: 66 ± 9.0 years, f/m = 12/63) were included in this study. Serial CXRs immediately after surgery until re-intervention or discharge were analyzed by a radiologist, blind to the date of redo surgery. Results: In 39 patients of group I (52 %) vs. 8 (10.7 %) in group II, abnormalities in the sternal wire and/or a midsternal stripe could be found (p < 0.0001): rotated wires (p = 0.003), shifted wires (p = 0.043), and ruptured wires (p = 0.312). Seven patients presented with combined wire abnormalities in group I vs. 0 in group II. Midsternal stripe sign could be detected in 26 patients of group I vs. 3 in group II (p < 0.0001). Sternal dehiscence was suspected based on the above mentioned abnormalities as early as three days postoperatively (Q1 = 2; Q3 = 8 days) in 39 patients, whereas clinical diagnosis of sternal dehiscence was delayed up to ten days postoperatively (Q1 = 7; Q3 = 13 days). Conclusions: Radiographic signs of sternal dehiscence could be detected before the clinical diagnosis was apparent and predicted sternal dehiscence in more than half of the patients.

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MD Ali Asghar Peivandi

Department of Cardiothoracic and Vascular Surgery
Johannes Gutenberg University Hospital

Langenbeckstraße 1

55131 Mainz

Germany

Telefon: + 496131172911

Fax: + 49 61 31 17 66 26

eMail: peivandi@uni-mainz.de