Influence Factors of Sternal Healing and Comparison of Different Sternal Closure Methods：A Retrospective Analysis

Background We determined the factors affecting sternum healing after a median sternotomy based on a retrospective analysis and compared the stability of different sternal closure techniques. Methods We collected information involving patients who underwent a median sternotomy in Changzhou First Hospital from 2014–2019 and had chest CT examinations 1–24 months postoperative, Main outcome includes the average of sternal healing score at the five specific anatomic levels and the adverse event of transverse displacement of sternum. Results In the short term healing group, Sternal score was only correlated with postoperative time (HR = 0.18, 95%CI:0.135–0.225, p < 0.001). In the long term healing group,old people had a higher risk of poor sternal healing than young (Age, HR=-0.028,95%CI:-0.05,-0.006, p = 0.013). Patients with left internal mammary artery grafting (LIMAG) had a high risk of poor sternal healing (HR=-0.444, CI:-0.869-0.019, p = 0.045).By binary logistic regression, It could be found that steel wire fixation was a favorable factor to prevent the transverse displacement of sternum (HR = 0.122, 95%CI:0.007–0.651, p = 0.047). Conclusion In summary, advanced age and internal mammary artery interception are risk factors that affect sternal healing based on imaging findings. this new method of sternal closure provides an effective way of ensuring sternal stability of both sternal plates and reduces the risk for complication after cardiac surgery in high-risk patients.