Sungur Elif Coşkun, Tütün Ufuk, Tekin Anıl
Department of Cardiovascular Surgery, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey.
J Tehran Heart Cent. 2020 Apr;15(2):81-83. doi: 10.18502/jthc.v15i2.4189.
The sternal foramen is an anatomical variation at the lower third of the sternum which carries the risk of life-threatening complications such as pneumothorax. It is usually asymptomatic and can be misinterpreted as an acquired lesion. The sternum is close to the mediastinal structures; the sternal foramen, thus, leaves the lung, heart, and great vessels unprotected during invasive procedures. A 61-year-old male patient was admitted to our emergency department with sudden-onset chest pain. Acute coronary syndrome was diagnosed by the cardiology department. Coronary angiography confirmed the diagnosis of coronary artery disease, and the patient underwent urgent coronary artery bypass grafting. During the exploration, sternotomy was performed with a proper incision. Two sternal images were obtained via the median incision, and a sternal foramen was detected intraoperatively. To the best of our knowledge, this is the first case of sternotomy to undergo open-heart surgery for coronary heart disease and to be diagnosed with the sternal foramen intraoperatively. It is of vital importance that surgeons and interventionists recognize the sternal foramen, which leaves the mediastinal structures unprotected, and take early precautions.
胸骨孔是胸骨下三分之一处的一种解剖变异，存在发生气胸等危及生命并发症的风险。它通常无症状，可能被误诊为后天性病变。胸骨靠近纵隔结构；因此，在侵入性操作过程中，胸骨孔会使肺、心脏和大血管失去保护。一名61岁男性患者因突发胸痛入住我院急诊科。心脏病科诊断为急性冠状动脉综合征。冠状动脉造影证实了冠状动脉疾病的诊断，患者接受了紧急冠状动脉搭桥手术。在探查过程中，通过适当的切口进行了胸骨切开术。经正中切口获取了两张胸骨图像，术中检测到一个胸骨孔。据我们所知，这是首例因冠心病接受心脏直视手术且术中被诊断出胸骨孔的胸骨切开术病例。外科医生和介入医生认识到使纵隔结构失去保护的胸骨孔并尽早采取预防措施至关重要。
