EP 296 Temporal Changes in Sternal Microcirculation Following Median Sternotomy in Coronary Artery Bypass Graft and Aortic Valve Replacement Surgeries

Abstract Introduction The temporal evolution of sternal microcirculation following median sternotomy in coronary artery bypass Graft and aortic valve replacement surgeries remains poorly characterised, despite its clinical relevance to postoperative wound healing and sternal complications. Methods Serial assessment of sternal microcirculation was performed using laser Doppler flowmetry in patients undergoing cardiac surgery via median sternotomy. Measurements were obtained preoperatively and at multiple postoperative time points up to postoperative day five. Changes in microcirculatory perfusion over time were analysed and correlated with clinical wound-healing outcomes. Results A marked reduction in sternal microcirculatory perfusion was observed in the early postoperative period compared with preoperative baseline. This was followed by a gradual, partial recovery over subsequent days. A subset of patients demonstrated persistent postoperative hypoperfusion, which was associated with delayed wound healing and increased requirement for wound-directed interventions. Conclusion Sternal microcirculation undergoes dynamic changes following sternotomy, characterised by early hypoperfusion and variable recovery. Serial laser Doppler monitoring may identify patients with abnormal microcirculatory trajectories who are at increased risk of impaired wound healing, offering a potential tool for early risk stratification and targeted postoperative management.