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Objective: Objective: To demonstrate the influence of systemic temperature during cardio-pulmonary by-pass(CBP)on the occurrence of sternal dehiscence. Methods: Over the period 1995-2000, 4495 operations were performed through the median sternotomy on CPB and systemic normothermia, of these 2627 (58.4%) coronary artery by-pass grafting(CABG).During the previous period 1987-1994, 3656 operations were performed on systemic moderate hypothermia, of these 1245 (34.1%) CABG. In both periods cold crystalloid cardioplegia and left internal thoracicartery (LITA)were used routinely. The wound reclosure was done 2 to 6 week safter primary operation, when wound swab cultures were negative. Results: After normothermic versus hypothermic CPB respectively: sternal dehiscence occurred in 49 patients (1%), including 33 after CABG vs. 65 (1.8%), including 42 after CABG. Early resternotomy for bleeding required 156 (3.5%) vs. 147 (4%) patients respectively (NS). Sternal dehiscence was significantly more frequent after CABG than after other operations in both periods (p<0.01). After normothermic vs. hypothermic CPB sternal dehiscence frequency was significantly lower for CABG (p<0.05), but insignificantly for other types of operations. Conclusions: LITA harvesting impairs median sternotomy wound healing, and moderate hypothermia significantly aggravates this phenomenon. Normothermic CPB significantly lowers the frequency of severe complications in median sternotomy healing in comparison with hypothermic one. Early resternotomy for excessive bleeding rate was irrelevant to the CBP temperature. (Clin. Exp. Med. Lett. 2005; 46(3):47-50)

Keywords: Sternal dehiscence, systemic normothermia, moderate hypothermia, CPB