First Report on Rigid Plate Fixation for Enhanced Sternal Closure in Minimally Invasive Cardiac Surgery: Safety and Outcomes

Introduction: This study reports of the use of a rigid-plate fixation (RPF) system designed for sternal closure after minimally invasive cardiac surgery (MICS). Methods: This retrospective analysis included all patients undergoing MICS with RPF (Zimmer Biomet, Jacksonville, FL, USA) at our instituti...

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Main Authors: Jules Miazza, Benedikt Reuthebuch, Florian Bruehlmeier, Ulisse Camponovo, Rory Maguire, Luca Koechlin, Ion Vasiloi, Brigitta Gahl, Luise Vöhringer, Oliver Reuthebuch, Friedrich Eckstein, David Santer
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Language:English
Published: MDPI AG 2024-12-01
Series:Bioengineering
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Online Access:https://www.mdpi.com/2306-5354/11/12/1280
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author Jules Miazza
Benedikt Reuthebuch
Florian Bruehlmeier
Ulisse Camponovo
Rory Maguire
Luca Koechlin
Ion Vasiloi
Brigitta Gahl
Luise Vöhringer
Oliver Reuthebuch
Friedrich Eckstein
David Santer
author_facet Jules Miazza
Benedikt Reuthebuch
Florian Bruehlmeier
Ulisse Camponovo
Rory Maguire
Luca Koechlin
Ion Vasiloi
Brigitta Gahl
Luise Vöhringer
Oliver Reuthebuch
Friedrich Eckstein
David Santer
author_sort Jules Miazza
collection DOAJ
description Introduction: This study reports of the use of a rigid-plate fixation (RPF) system designed for sternal closure after minimally invasive cardiac surgery (MICS). Methods: This retrospective analysis included all patients undergoing MICS with RPF (Zimmer Biomet, Jacksonville, FL, USA) at our institution. We analyzed in-hospital complications, as well as sternal complications and sternal pain at discharge and at follow-up 7 to 14 months after surgery. Results: Between June and December 2023, 12 patients underwent RPF during MICS, of which 9 patients were included in the study. The median (IQR) age was 64 years (63 to 71) and two patients (22%) were female. All patients underwent aortic valve replacement, with two patients (22%) undergoing concomitant aortic surgery. RPF was successfully performed in all patients. ICU and in-hospital stay were 1 day (1 to 1) and 9 days (7 to 13), respectively. Patients were first mobilized in the standing position on postoperative day 2 (2 to 2). Four patients (44%) required opiates on the general ward. In-hospital mortality was 0%. At discharge, rates of sternal pain, sternal instability or infection were 0%. After a follow-up time of 343.6 days (217 to 433), median pain intensity using the Visual Analog Scale was 0 (0 to 2). Forty-four percent (<i>n</i> = 4) of patients reported pain at rest. No sternal complications (sternal dehiscence, sternal mal-union, sternal instability, superficial wound infections and deep sternal wound infections) were reported. Conclusions: In the evolving landscape of cardiac therapies with incentives to reduce surgical burden, RPF showed safety and feasibility. It might become an important tool for sternal closure in minimally invasive cardiac surgery.
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spelling doaj-art-fa0230d8e9184fa08ab518fbf53ad8a02024-12-27T14:11:43ZengMDPI AGBioengineering2306-53542024-12-011112128010.3390/bioengineering11121280First Report on Rigid Plate Fixation for Enhanced Sternal Closure in Minimally Invasive Cardiac Surgery: Safety and OutcomesJules Miazza0Benedikt Reuthebuch1Florian Bruehlmeier2Ulisse Camponovo3Rory Maguire4Luca Koechlin5Ion Vasiloi6Brigitta Gahl7Luise Vöhringer8Oliver Reuthebuch9Friedrich Eckstein10David Santer11Department of Cardiac Surgery, University Hospital of Basel, 4031 Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital of Basel, 4031 Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital of Basel, 4031 Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital of Basel, 4031 Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital of Basel, 4031 Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital of Basel, 4031 Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital of Basel, 4031 Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital of Basel, 4031 Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital of Basel, 4031 Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital of Basel, 4031 Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital of Basel, 4031 Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital of Basel, 4031 Basel, SwitzerlandIntroduction: This study reports of the use of a rigid-plate fixation (RPF) system designed for sternal closure after minimally invasive cardiac surgery (MICS). Methods: This retrospective analysis included all patients undergoing MICS with RPF (Zimmer Biomet, Jacksonville, FL, USA) at our institution. We analyzed in-hospital complications, as well as sternal complications and sternal pain at discharge and at follow-up 7 to 14 months after surgery. Results: Between June and December 2023, 12 patients underwent RPF during MICS, of which 9 patients were included in the study. The median (IQR) age was 64 years (63 to 71) and two patients (22%) were female. All patients underwent aortic valve replacement, with two patients (22%) undergoing concomitant aortic surgery. RPF was successfully performed in all patients. ICU and in-hospital stay were 1 day (1 to 1) and 9 days (7 to 13), respectively. Patients were first mobilized in the standing position on postoperative day 2 (2 to 2). Four patients (44%) required opiates on the general ward. In-hospital mortality was 0%. At discharge, rates of sternal pain, sternal instability or infection were 0%. After a follow-up time of 343.6 days (217 to 433), median pain intensity using the Visual Analog Scale was 0 (0 to 2). Forty-four percent (<i>n</i> = 4) of patients reported pain at rest. No sternal complications (sternal dehiscence, sternal mal-union, sternal instability, superficial wound infections and deep sternal wound infections) were reported. Conclusions: In the evolving landscape of cardiac therapies with incentives to reduce surgical burden, RPF showed safety and feasibility. It might become an important tool for sternal closure in minimally invasive cardiac surgery.https://www.mdpi.com/2306-5354/11/12/1280cardiac surgeryrigid plate fixationenhanced sternal closureaortic valve replacementministernotomypartial upper hemisternotomy
spellingShingle Jules Miazza
Benedikt Reuthebuch
Florian Bruehlmeier
Ulisse Camponovo
Rory Maguire
Luca Koechlin
Ion Vasiloi
Brigitta Gahl
Luise Vöhringer
Oliver Reuthebuch
Friedrich Eckstein
David Santer
First Report on Rigid Plate Fixation for Enhanced Sternal Closure in Minimally Invasive Cardiac Surgery: Safety and Outcomes
Bioengineering
cardiac surgery
rigid plate fixation
enhanced sternal closure
aortic valve replacement
ministernotomy
partial upper hemisternotomy
title First Report on Rigid Plate Fixation for Enhanced Sternal Closure in Minimally Invasive Cardiac Surgery: Safety and Outcomes
title_full First Report on Rigid Plate Fixation for Enhanced Sternal Closure in Minimally Invasive Cardiac Surgery: Safety and Outcomes
title_fullStr First Report on Rigid Plate Fixation for Enhanced Sternal Closure in Minimally Invasive Cardiac Surgery: Safety and Outcomes
title_full_unstemmed First Report on Rigid Plate Fixation for Enhanced Sternal Closure in Minimally Invasive Cardiac Surgery: Safety and Outcomes
title_short First Report on Rigid Plate Fixation for Enhanced Sternal Closure in Minimally Invasive Cardiac Surgery: Safety and Outcomes
title_sort first report on rigid plate fixation for enhanced sternal closure in minimally invasive cardiac surgery safety and outcomes
topic cardiac surgery
rigid plate fixation
enhanced sternal closure
aortic valve replacement
ministernotomy
partial upper hemisternotomy
url https://www.mdpi.com/2306-5354/11/12/1280
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