Volume 10 Supplement 1
Defining severity of adhesions during redo cardiac surgery using Preoperative Computed Tomography scans and impact on surgical approach
© Siah et al. 2015
Published: 16 December 2015
Mortality and morbidity of redo cardiac surgery is higher due to the presence of adhesions between cardiac structures and the chest wall. Preoperative Computed Tomography (CT) scans can help mitigate the risk of injury during redo surgery. Some surgeons use findings from preoperative CT scans to modify their surgical approach but its use is not universal.
We sought to determine if CT scans and time elapsed from initial cardiac surgery can predict the severity of adhesions, and whether CT scan findings are associated with the use of preventative surgical strategies.
We studied 92 patients referred for redo cardiac surgery. CT scan findings, operation notes findings, use of preventative surgical strategies, mortality and date of initial cardiac surgery were recorded.
In the study, 58 patients had preoperative CT scans and 34 patients did not. Preoperative CT scans identified 36 patients with moderate adhesions and 22 patients with severe adhesions. 13 out of 36 patients (33%) with moderate adhesions on CT scans had moderate adhesions during surgery. 16 out of 22 patients (73%) with severe adhesions on CT scans had severe adhesions during surgery. No association was found between the degree of adhesions on preoperative CT scans and surgical findings (p = 0.486). Severe adhesions on preoperative CT scans are not associated with greater use of preventative surgical strategies (p = 0.134). No significant difference in mortality was found in patients who had preoperative CT scan and those who did not (p = 0.070). No association was found between the severity of adhesions and time elapsed from initial cardiac surgery (p = 0.695).
Preoperative CT scans and time elapsed from initial cardiac surgery are not useful in predicting the severity of adhesions in redo cardiac surgery. Severe adhesions on CT scans are not associated with greater use of preventative surgical strategies.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.