JTCVS open · 2026
Sternal precautions in high-risk cardiac surgery patients: Impact of a novel movement strategy and a wearable external sternal support device.
СтатьяНазвание и аннотация: Перевод в очереди
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Siemens Janessa, Codispodi Kelly, Yan Weiang, Kent David, Kumar Kanwal, Arora Rakesh C
Аннотация
OBJECTIVE: The median sternotomy remains the most common surgical approach in most centers performing cardiac surgery. Patients are traditionally required to undergo 6 to 8 weeks of postoperative sternal precautions, placing significant limitations on their daily activities. The aim of this study was to determine the safety of an evidence-based movement strategy (Moving Safely) with and without the use of a wearable external sternal support device on patient quality of life after cardiac surgery.
METHODS: A total of 150 patients at high risk for sternal complications were recruited prospectively between 2017 and 2018 at a single tertiary cardiac center. Patients were divided into 3 groups: standard sternal precautions, Moving Safely, and Moving Safely with a wearable external sternal support device. The primary outcome was patient health-related quality of life, assessed using the EuroQol 5-dimension 5-level and the EuroQoL visual analogue scale, preoperatively, at discharge, and at 8 weeks postsurgery. Simple spirometry was also performed to assess respiratory function at these time points.
RESULTS: All patients reported better health-related quality of life on the EuroQol 5-dimension 5-level and EuroQoL visual analogue scale at time of follow-up compared with time of discharge (P < .001, respectively). Similar improvements were seen in forced expiratory volume in 1 second and forced vital capacity (P < .001, respectively). No significant differences were observed in the incidence of sternal complications among the 3 treatment groups.
CONCLUSIONS: The use of a Moving Safely protocol after cardiac surgery was not associated with adverse events and improved patient health-related quality of life compared with traditional sternal precautions. The support provided by a wearable external sternal support device did not improve patient health-related quality of life after cardiac surgery.
METHODS: A total of 150 patients at high risk for sternal complications were recruited prospectively between 2017 and 2018 at a single tertiary cardiac center. Patients were divided into 3 groups: standard sternal precautions, Moving Safely, and Moving Safely with a wearable external sternal support device. The primary outcome was patient health-related quality of life, assessed using the EuroQol 5-dimension 5-level and the EuroQoL visual analogue scale, preoperatively, at discharge, and at 8 weeks postsurgery. Simple spirometry was also performed to assess respiratory function at these time points.
RESULTS: All patients reported better health-related quality of life on the EuroQol 5-dimension 5-level and EuroQoL visual analogue scale at time of follow-up compared with time of discharge (P < .001, respectively). Similar improvements were seen in forced expiratory volume in 1 second and forced vital capacity (P < .001, respectively). No significant differences were observed in the incidence of sternal complications among the 3 treatment groups.
CONCLUSIONS: The use of a Moving Safely protocol after cardiac surgery was not associated with adverse events and improved patient health-related quality of life compared with traditional sternal precautions. The support provided by a wearable external sternal support device did not improve patient health-related quality of life after cardiac surgery.