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American Association for Thoracic Surgery Aortic Symposium 2010, New York

Packing the chest –harbinger of death or a useful hemostatic manoeuvre in aortic surgery – a matched case-control study.

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American Association for Thoracic Surgery Aortic Symposium 2010, New York

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  1. Packing the chest –harbinger of death or a useful hemostatic manoeuvre in aortic surgery – a matched case-control study. Ishtiaq A Rahman,  Mahmoud Loubani, Aaron Ranasinghe, Reena Panchal, Viv Barnett, Timothy R Graham, Ian C Wilson, Domenico Pagano, Steve Rooney, Jorge G Mascaro,  Robert S Bonser, American Association for Thoracic Surgery Aortic Symposium 2010, New York

  2. Objectives Packing the field with swabs may be the last resort for persistent intra-operative bleeding. We aimed to compare outcomes in such cases versus matched controls.

  3. Methods Patients undergoing aortic surgery via median sternotomy identified (1997-2009). Patients requiring mediastinal packing individually matched via operative database for controls. Matching performed by investigators blinded to outcome for operation type, urgency, age, gender, operative priority, number of previous operations, era of operation, vascular pathology.

  4. Results Aortic procedures via median sternotomy n=790 Patients requiring packing n=49 Non-packed Controls n=49

  5. Results

  6. Results

  7. Results – Transfusions in Theatre

  8. Results – Transfusions on ITU

  9. Results

  10. Results

  11. Results – long term survival p=0.192

  12. Conclusion Packing is a reasonable treatment option when primary haemostasis cannot be achieved. Similar survival to matched controls, without an increase in infective complications, but is associated with an increased transfusion and ventilation time. It remains an important bail-out technique to secure haemostasis in this high risk population.

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