Madjarov Jeko M, Katz Michael G, Kumar Arvind, Gubara Sarah M, Madzharov Svetozar, Madjarova Sophia, Robiscek Francis
Department of Cardiothoracic Surgery, Sanger Heart and Vascular Institute, Charlotte, NC, USA.
Cardiovascular Research Center, Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Heart Surg Forum. 2020 Feb 25;23(1):E058-E060. doi: 10.1532/hsf.2783.
In recent decades, new information has arisen regarding sternal healing and extended indications for using rigid plate fixation in patients during cardio-thoracic procedures. Three randomized controlled multicenter clinical trials recently demonstrated positive results after rigid plate fixation, including reduced sternal complications and decreased length of hospital stay. However, redo-sternotomy after sternal reconstruction utilizing rigid fixation has not been previously delineated in surgical literature. This case highlights the technical challenges of performing a median sternotomy for cardiac surgery after sternal reconstruction with bilateral longitudinal plating.
近几十年来，出现了有关胸骨愈合以及在心胸手术中对患者使用刚性钢板固定的扩展适应症的新信息。最近三项随机对照多中心临床试验表明，刚性钢板固定术后有积极效果，包括减少胸骨并发症和缩短住院时间。然而，外科文献中此前尚未描述过在使用刚性固定进行胸骨重建后再次进行胸骨切开术的情况。本病例突出了在双侧纵向钢板胸骨重建后进行心脏手术正中胸骨切开术的技术挑战。
