Retrosternal Deformations after Coronary Artery Bypass Surgery Using Statistical Shape Analysis

Abstract

Introduction: In this study, we aimed to evaluate the anatomical deformations of the major vascular structures in the retrosternal area caused by adhesions following coronary artery bypass grafting (CABG). Methods: This single-center, retrospective study included a total of 40 patients with a previous CABG who were admitted to our emergency unit for any reason and underwent a contrast-enhanced chest computed tomography (patient group) and 40 patients without previous cardiac surgery (control group) between January 2018 and November 2019. The retrosternal area was compared between the groups using the statistical shape analysis method. The distance between the sternum and the ascending aorta and pulmonary artery was measured and anatomical deformations of the retrosternal area were examined. Results: There was a statistically significant difference in the anatomical structures of the retrosternal area between the patient and control groups (P<0.001). The distance from the midsternal line to the highest point of the pulmonary artery was statistically significantly shorter in the patient group, compared to the control group (P=0.013). The distance from the sternum to the ascending aorta was also shorter in the patient group, although it did not reach statistical significance (P>0.05). Conclusions: Our study results showed narrowing of the retrosternal area following CABG and a shorter distance from the sternum to the pulmonary artery than the ascending aorta. Based on these findings, surgeons should be cautious about possible injuries in patients requiring cardiac surgery with repeated median sternotomy.