Resternotomy in patients with valved conduits adherent to the sternum

• Published in: The Annals of thoracic surgery Vol. 52; no. 3; pp. 569 - 571
• Main Authors: DeLeon, Serafin Y., Ilbawi, Michel N., Tubeszewski, Kate, Wilson, William R., Quinones, Jose A., Roberson, David A., Sulayman, Rabi F.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.1991; Elsevier Science
• Subjects: Adolescent; Adult; Biological and medical sciences; Cardiac Surgical Procedures - methods; Child; Child, Preschool; Humans; Infant; Intraoperative Complications - prevention & control; Medical sciences; Reoperation; Sternum - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Human; Sternotomy; Reoperation; Treatment; Sternum; Surgery; Cardiovascular disease; Complication; Adhesion
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/0003-4975(91)90934-I

Twenty-two patients with valved conduits adherent to the sternum underwent resternotomy. Mean age was 10 ± 6 years, and mean conduit age was 4 ± 4 years. Diagnoses were d-transposition (7), truncus arteriosus (7), univentricular heart (6), Taussig-Bing anomaly (1), and corrected transposition (1). The majority of patients (68%) had reoperation for outgrown or degenerated conduits. In 17 patients, the sternum was opened with a chisel. Two of these patients sustained conduit neointimal collapse from manipulation, and 3 had conduit tear requiring immediate cardiopulmonary bypass through the femoral vessels. In the last 5 patients, the sternum was opened above and below the conduit, and the inner table was chiseled and left attached to the conduit avoiding injury and undue conduit manipulation. Cardiopulmonary bypass and operation were carried out uneventfully. We believe that the recent technique described provides a safe alternative approach to valved conduits adherent to the sternum.