Continuous Half-thickness Suture Outside of the Pectinate Muscles in the Right Atrium Incision in Adult Patients Undergoing Cardiac Surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 ZHANGQing-chun , YINHai-hui , LUZhong , SUNYun , WUYi-jun , YANZhong-ya

Department of Cardiac Surgery, Anhui Provincial Hospital, Hefei 230001, P. R. China;

Corresponding?author：

ZHANGQing-chun, Email: zhangqingchun2006@aliyun.com

Keywords：

Continuous half-thickness suture; Pectinate muscles; Right atrium incision; Cardiac surgery

DOI：

10.7507/1007-4848.20150216

Video：

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Objective To evaluate the continuous half-thickness suture outside of the pectinate muscles in the right atrium incision in adult patients undergoing cardiac surgery. Methods A total of 1 040 consecutive adult patients undergoing cardiac surgery by the right atrium incision with cardiopulmonary bypass (CPB) were randomly divided into a control group (n=518 with 236 males and 282 females at mean age of 44.55 years) and a trial group (n=522 with 242 males and 280 females at mean age 45.75 years) between January 2010 and June 2014. The right atrium incision was sutured by continuous full-thickness suture in the control group and sutured by continuous half-thickness suture in the trial group. After the suture, the bleeding in the right atrium incision was recorded. Results All patients underwent the open-heart operation. Seven patients died of postoperative low cardiac syndrome including four patients in the control group and 3 patients in the trial group. The heart incision was inspected before suturing the pericardium. A total of 203 patients of local active bleeding were stitched again in the right atrium incision in the control group. Only 26 patients were stitched again in the trial group (P<0.001). In the cases of re-exploration for bleeding or tamponade after cardiac operation, 3 patients of bleeding due to the right atrium incision were confirmed in the control group, and no one was confirmed in the trial group. Conclusion The continuous half-thickness suture in the right atrium incision can prevent the incision bleeding, and avoid locally stitching again in adult patients undergoing cardiac surgery.

Citation： ZHANGQing-chun, YINHai-hui, LUZhong, SUNYun, WUYi-jun, YANZhong-ya. Continuous Half-thickness Suture Outside of the Pectinate Muscles in the Right Atrium Incision in Adult Patients Undergoing Cardiac Surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(9): 866-869. doi: 10.7507/1007-4848.20150216 Copy

1.	吳龍, 孫宗全, 蔣雄剛, 等. 心臟手術后二次開胸止血94例. 中國胸心血管外科臨床雜志, 2005, 12(5):372-373.
2.	Hall TS, Brevetti GR, Skoultchi AJ, et al. Re-exploreation for hemorrage following open heart surgery differentiation on the causes of bleeding and the impact on patients outcomes. Ann Thorac Cardiovasc Surg, 2001, 7(6):352-357.
3.	Fukuda Y, Tanaka H, Motoji Y, et al. Utility of combining assessment of right ventricular function and right atrial remodeling as a prognostic factor for patients with pulmonary hypertension. Int J Cardiovasc Imaging, 2014, 30(7):1269-1277.
4.	武長禮, 肖學鈞. 三尖瓣關閉不全與右心房重構關系研究進展. 嶺南心血管病雜志, 2012, 18(3):317-319.
5.	Voigt N, Heijman J, Wang Q, et al. Cellular and molecular mechanisms of atrial arrhythmogenesis in patients with paroxysmal atrial fibrillation. Circulation, 2014, 129(2):145-156.
6.	Canadyova J, Zmeko D, Mokracek A. Re-exploration for bleeding or tamponade after cardiac operation. Interact Cardiovasc Thorac Surg, 2012, 14(6):704-708.
7.	申聰玉, 趙錦寧, 鐘泰迪. 體外循環心臟手術患者圍手術期大量出血的危險因素分析. 中華醫學雜志, 2012, 95(5):316-319.
8.	Balaguer JM, Yu C, Byrne JG, et al. Contribution of endogenous bradykinin to fibrinolysis, inflammation, and blood product transfusion following cardiac surgery:a randomized clinical trial. Clin Pharmacol Ther, 2013, 93(4):326-334.
9.	Kaspereit F, Hoffmann S, Pragst I, et al. Prothrombin complex concentrate mitigates diffuse bleeding after cardiopulmonary bypass in a porcine model. Br J Anaesth, 2010, 105(5):576-582.
10.	Ferraris VA, Brown JR, Despotis, et al. 2011 update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines. Ann Thorac Surg, 2011, 91(3):944-982.
11.	Kindo M, Hoang Minh T, Gerelli S, et al. Plasma fibrinogen level on admission to the intensive care unit is a powerful predictor of postoperative bleeding after cardiac surgery with cardiopulmonary bypass. Thromb Res, 2014, 134(2):360-368.

1. 吳龍, 孫宗全, 蔣雄剛, 等. 心臟手術后二次開胸止血94例. 中國胸心血管外科臨床雜志, 2005, 12(5):372-373.
2. Hall TS, Brevetti GR, Skoultchi AJ, et al. Re-exploreation for hemorrage following open heart surgery differentiation on the causes of bleeding and the impact on patients outcomes. Ann Thorac Cardiovasc Surg, 2001, 7(6):352-357.
3. Fukuda Y, Tanaka H, Motoji Y, et al. Utility of combining assessment of right ventricular function and right atrial remodeling as a prognostic factor for patients with pulmonary hypertension. Int J Cardiovasc Imaging, 2014, 30(7):1269-1277.
4. 武長禮, 肖學鈞. 三尖瓣關閉不全與右心房重構關系研究進展. 嶺南心血管病雜志, 2012, 18(3):317-319.
5. Voigt N, Heijman J, Wang Q, et al. Cellular and molecular mechanisms of atrial arrhythmogenesis in patients with paroxysmal atrial fibrillation. Circulation, 2014, 129(2):145-156.
6. Canadyova J, Zmeko D, Mokracek A. Re-exploration for bleeding or tamponade after cardiac operation. Interact Cardiovasc Thorac Surg, 2012, 14(6):704-708.
7. 申聰玉, 趙錦寧, 鐘泰迪. 體外循環心臟手術患者圍手術期大量出血的危險因素分析. 中華醫學雜志, 2012, 95(5):316-319.
8. Balaguer JM, Yu C, Byrne JG, et al. Contribution of endogenous bradykinin to fibrinolysis, inflammation, and blood product transfusion following cardiac surgery:a randomized clinical trial. Clin Pharmacol Ther, 2013, 93(4):326-334.
9. Kaspereit F, Hoffmann S, Pragst I, et al. Prothrombin complex concentrate mitigates diffuse bleeding after cardiopulmonary bypass in a porcine model. Br J Anaesth, 2010, 105(5):576-582.
10. Ferraris VA, Brown JR, Despotis, et al. 2011 update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines. Ann Thorac Surg, 2011, 91(3):944-982.
11. Kindo M, Hoang Minh T, Gerelli S, et al. Plasma fibrinogen level on admission to the intensive care unit is a powerful predictor of postoperative bleeding after cardiac surgery with cardiopulmonary bypass. Thromb Res, 2014, 134(2):360-368.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Continuous Half-thickness Suture Outside of the Pectinate Muscles in the Right Atrium Incision in Adult Patients Undergoing Cardiac Surgery

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