title: Thermoreactive nitinol clips: Propensity score comparison with Robicsek technique.
abstract: OBJECTIVE
  To compare the use of thermoreactive nitinol clips with the classic Robicsek technique for treatment of sternal dehiscence after cardiac surgery.
  
  
  METHODS
  Eighty-two (2.3%) of 3564 open heart surgery patients underwent reoperation for sternal dehiscence between October 2011 and 2012. Prospectively collected data from 26 (31%) consecutive patients who underwent reoperation using thermoreactive nitinol clips were compared with those of a retrospective cohort of 42 (51.2%) who were treated with the classic Robicsek technique. To overcome baseline and operative variations, we constructed a propensity model using logistic regression.
  
  
  RESULTS
  Overall mortality occurred in 3 (5%) patients and a second revision was performed in 2 (7.7%) in the nitinol clip group and 2 (6.3%) in the control group (p > 0.05). Postoperative results were similar except for the mean time of operation which was significantly shorter in the nitinol clip group, and patients in this group required substernal dissection slightly less frequently than those in the control group.
  
  
  CONCLUSIONS
  Thermoreactive nitinol clips allow the surgeon to perform a rapid and less challenging technique for sternal reoperations, without additional complications. Using this technique in an identical group with a finite sample size, we accomplished similar early results to those of the classic Robicsek technique.
authors.affiliation: Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Sabit
authors.initials: S
authors.lastname: Sarıkaya
authors.affiliation: Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Eray
authors.initials: E
authors.lastname: Aksoy
authors.affiliation: Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Yücel
authors.initials: Y
authors.lastname: Özen
authors.affiliation: Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Dedemoğlu
authors.affiliation: Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Mustafa Mert
authors.initials: MM
authors.lastname: Özgür
authors.affiliation: Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Fuat
authors.initials: F
authors.lastname: Büyükbayrak
authors.affiliation: Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey imkbkirali@yahoo.com.
authors.forename: Kaan
authors.initials: K
authors.lastname: Kırali
mesh_terms: D000368:Aged; D000497:Alloys; D001831:Body Temperature; D006348:Cardiac Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation / Q000379:methods* / Q000401:mortality; D012189:Retrospective Studies; D056346:Sternotomy / Q000009:adverse effects*; D013249:Sternum / Q000601:surgery*; D013525:Surgical Instruments; D013529:Surgical Wound Dehiscence / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome; D058106:Wound Closure Techniques / Q000295:instrumentation*
chemical_list: D000497:Alloys; C013616:nitinol
keywords: Reconstructive surgical procedures; reoperation; sternotomy; surgical instruments; surgical wound dehiscence; wound closure techniques