{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T10:15:42Z","timestamp":1782123342832,"version":"3.54.5"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Delayed sternal closure (DSC) is a well-established strategy used to manage patients with hemodynamic instability and perioperative coagulopathy following cardiac surgery. The study aims to present our 15-year surgical experiences with DSC.<\/jats:p>\n                  <jats:p>Between 2007 and 2022, DSC was performed in 227 out of 14,210 patients (1.7%) who underwent cardiac surgery at our institution. Perioperative data, outcomes, and long-term survival were analyzed. Quality of life (QoL) was assessed utilizing the EuroQol-5D-5L questionnaire.<\/jats:p>\n                  <jats:p>Indications for DSC included low cardiac output syndrome (LCOS) (44.1%) and coagulopathy during the index procedure (32.2%), as well as postoperative tamponade (22.9%). In coronary artery bypass grafting, LCOS was the primary indication for DSC (72.7%), whereas in acute type A aortic dissection, coagulopathy was the leading indication (70.6%). For other procedures, DSC indications were more evenly distributed. The overall 30-day survival was 57.5%, with survival rates of 43.3% for LCOS, 72.0% for coagulopathy, and 65.4% for tamponade. Multivariate logistic regression identified body mass index, postoperative renal replacement therapy, aggravated heart failure, and intraoperative packed red blood cell transfusion as negatively associated with 30-day survival. The mean follow-up period was 6.58\u2009\u00b1\u20093.19 years. Younger patients and DSC patients upon bleeding related indications reported higher QoL in comparison to older patients and patients with LCOS. Longer follow-up interval correlated with higher QoL.<\/jats:p>\n                  <jats:p>The study emphasizes the significant impact of LCOS on outcomes in patients undergoing DSC. We provide QoL data demonstrating good rehabilitation potential upon survival of the acute phase.<\/jats:p>","DOI":"10.1055\/a-2607-6390","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T20:19:38Z","timestamp":1747253978000},"page":"028-038","source":"Crossref","is-referenced-by-count":2,"title":["Delayed Sternal Closure in Heart Surgery: Outcomes and Quality of Life"],"prefix":"10.1055","volume":"74","author":[{"given":"Henrik","family":"Heuer","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, BY, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyang","family":"Song","sequence":"additional","affiliation":[{"name":"Institute of Mathematics, Ludwig-Maximilian University Munich, Munich, BY, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Hegner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Regensburg, Regensburg, BY, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Truong","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, BY, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigrid","family":"Wiesner","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, BY, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Terrazas","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, BY, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Larisch","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, BY, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Christoph","family":"Aigner","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University Medical Center Regensburg, Regensburg, BY, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Floerchinger","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, BY, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christof","family":"Schmid","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, BY, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, BY, Germany"},{"name":"Department of Occupational Medicine, University Medical Center Regensburg, Regensburg, BY, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1111\/j.1540-8191.2008.00745.x","article-title":"In-hospital outcomes of delayed sternal closure after open cardiac surgery","volume":"24","author":"K Hashemzadeh","year":"2009","journal-title":"J Card Surg"},{"issue":"05","key":"ref2","first-page":"1146","article-title":"Open chest management after cardiac operations: outcome and timing of delayed sternal closure","volume":"40","author":"U 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