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

Interact Cardiovasc Thorac Surg. 2016 Apr;22(4):472-9. doi: 10.1093/icvts/ivv367. Epub 2016 Jan 5.

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.

Keywords: Cardiac; Cardiac surgery; Complications; Computerized tomography; Imaging; Meta-analysis; Reoperation; Statistics.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Aortography / methods*
  • Cardiac Surgical Procedures* / adverse effects
  • Cardiac Surgical Procedures* / mortality
  • Chi-Square Distribution
  • Computed Tomography Angiography*
  • Humans
  • Odds Ratio
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Postoperative Complications / prevention & control*
  • Predictive Value of Tests
  • Preoperative Care / methods*
  • Protective Factors
  • Reoperation
  • Risk Factors
  • Sternotomy* / adverse effects
  • Sternotomy* / mortality
  • Treatment Outcome