A meta-analysis of computerized tomography scan for reducing complications following repeat sternotomy for cardiac surgery

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Abstract

Cardiac reoperation carries additional risks compared with surgery in patients who are sternotomy-naïve. To identify if preoperative computerized tomography (CT) can reduce this risk, we performed a systematic review of the literature and meta-analysis. Literature search identified 178 studies of which 4 retrospective cohort studies incorporating 900 patients met inclusion criteria. There were no statistically significant differences in the risk of death, re-entry injury, renal failure or perfusion/ischaemic times. CT scan reduced the risk of stroke by 0.42 [95% confidence interval (CI): 0.19-0.93, P = 0.03] and a composite of major complications by 0.65 (95% CI: 0.47-0.88, P = 0.006). The use of preoperative cross-sectional imaging to reduce the risk of complications following cardiac reoperation is advocated.

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Kirmani, B. H., Brazier, A., Sriskandarajah, S., Azzam, R., & Keenan, D. J. (2016). A meta-analysis of computerized tomography scan for reducing complications following repeat sternotomy for cardiac surgery. Interactive Cardiovascular and Thoracic Surgery, 22(4), 472–479. https://doi.org/10.1093/icvts/ivv367

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