Sternal instability after coronary artery bypass grafting (CABG) is a serious complication. Obese patients are at high risk for sternal instability after CABG. This study was conducted to assess the positive impact of double-wire sternal closure on sternal instability. A total of 200 obese patients with a body mass index ≥ 30 kg/m undergoing isolated CABG with left internal mammary artery (LIMA) graft were randomly assigned to sternal closure either by eight single wires ( = 100) or by a combination of four double wires and four single wires. There was a total of 21 cases with sternal instability: 5 cases (i.e., 5%) in the double-wire group versus 16 cases (16%) in the single-wire group ( = 0.019). Logistic regression analysis showed sternal closure via double wires as an independent protection factor (odds ratio [OR]: 0.276; = 0.029). Smoking (OR: 5.5; = 0.006) and postoperative delirium (OR: 3.5; = 0.033) turned out to be independent risk factors for the development of sternal instability. Double-wire sternal closure significantly reduces postoperative sternal instability in obese patients undergoing isolated CABG with LIMA graft.
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