Risk of Sternal Wound Infection in Bilateral Skeletonized Internal Thoracic Artery in Coronary Artery Bypass Grafting: A Propensity Score Matching Analysis

C. Burgard; J. Jahn; W. te Gussinklo; M. Karck; R. Arif; B. Dib

doi:10.1055/s-0044-1780554

The Thoracic and Cardiovascular Surgeon, Inhaltsverzeichnis

Thorac Cardiovasc Surg 2024; 72(S 01): S1-S68
DOI: 10.1055/s-0044-1780554

Saturday, 17 February

Koronarchirurgie in speziellen Patientengruppen

Risk of Sternal Wound Infection in Bilateral Skeletonized Internal Thoracic Artery in Coronary Artery Bypass Grafting: A Propensity Score Matching Analysis

Authors

C. Burgard

¹Campus Im Neuenheimer Feld, Heidelberg, Deutschland
J. Jahn

²Im Neuenheimer Feld 420, Heidelberg, Deutschland
W. te Gussinklo

³Department of Cardiac Surgery University Hospital Heidelberg, Heidelberg, Deutschland
M. Karck

⁴University Hospital Heidelberg, Heidelberg, Deutschland
R. Arif

⁴University Hospital Heidelberg, Heidelberg, Deutschland
B. Dib

²Im Neuenheimer Feld 420, Heidelberg, Deutschland

Abstract

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Background: Sternal wound infection (SWI) is a serious complication of coronary artery bypass surgery. This study aims to evaluate the relative risk of sternal wound infection in a propensity score matched collective in patients undergoing bilateral internal thoracic artery bypass grafting.

Methods: Patients undergoing isolated coronary artery bypass grafting (CABG) were retrospectively analyzed in our center between 2020 and 2023. In this time-frame 1774 patients were analyzed. After propensity score matching 591 patients were identified. 291 patients received both internal mammary artery (BIMA), 291 patients received non-BIMA CABG. Risk factors for sternal wound infections were evaluated.

Results: The incidence of sternal wound infection in BIMA and non-BIMA patients was similar (1.4% vs. 3.8%, p = 0.067). There was neither a difference in superficial (1% vs. 2.4%, p = 0.202) nor in deep wound infection (0.3% vs. 1.4%, p = 0.373) in both groups. Female gender (p = 0.005), diabetes (p < 0.001), peripheral arterial vascular disease (p = 0.017), postoperative delirium (p < 0.001) and long ICU stay (p = 0.041) were determined as risk factors for SWI.

Conclusion: Harvesting of bilateral internal mammary arteries in skeletonized technique for coronary artery bypass grafting carries in general no additional risk of sternal infection in comparison to non-BIMA CABG patients.