Internal mammary artery pseudoaneurysm following a robicsek sternal closure

Albarrán, Ali Ayaon; Gonzalez, J. P.; Cabrero, Teresa Hernández; Villegas, Elkin González

doi:10.1111/jocs.13119

Cited by 3 publications

(1 citation statement)

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“…The measurements are performed at the level of the manubrium, as well as at the level of the 3rd and 5th intercostal spaces. Measurements are performed to find the optimal screw length to avoid loosening and complications due to perforation of the dorsal bone cortex by the screws [19]. To achieve a better sternum approximation, up to three single sternal wires can be added between the envisioned implantation sites of the SL360, thus allowing for a better positioning of the system.…”

Section: Surgical Techniquementioning

confidence: 99%

Combined Band and Plate Fixation as a New Individual Option for Patients at Risk of Sternal Complications after Cardiac Surgery: A Single-Center Experience

et al. 2023

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Due to the advent of interventional therapies for low- and intermediate-risk patients, case complexity has increased in cardiac surgery over the last decades. Despite the surgical progress achieved to keep up with the increase in the number of high-risk patients, the prevention of sternal complications remains a challenge requiring new, individualized sternal closure techniques. The aim of this study was to evaluate the safety and feasibility, as well as the in-hospital and long-term outcomes, of enhanced sternal closure with combined band and plate fixation using the new SternaLock® 360 (SL360) system as an alternative to sternal wiring. From 2020 to 2022, 17 patients underwent enhanced sternal closure using the SL360 at our institution. We analyzed perioperative data, as well as clinical and radiologic follow-up data. The results were as follows: In total, 82% of the patients were treated with the SL360 based on perioperative risk factors, while in 18% of cases, the SL360 was used for secondary closure due to sternal instability. No perioperative complications were observed. We obtained the follow-up data of 82% of the patients (median follow-up time: 141 (47.8 to 511.5) days), showing no surgical revision, no sternal instability, no deep wound infections, and no sternal pain at the follow-up. In one case, a superficial wound infection was treated with antibiotics. In conclusion, enhanced sternal closure with the SL360 is easy to perform, effective, and safe. This system might be considered for both primary and secondary sternal closure in patients at risk of sternal complications.

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Section: Surgical Techniquementioning

confidence: 99%

Combined Band and Plate Fixation as a New Individual Option for Patients at Risk of Sternal Complications after Cardiac Surgery: A Single-Center Experience

et al. 2023

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Safety and effectiveness of transcatheter embolization in the treatment of internal mammary artery injuries

et al. 2017

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Closure of the sternum with anchoring of the steel wires: Systematic review and meta-analysis

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Rodrigues

et al. 2018

The Journal of Thoracic and Cardiovascular Surgery

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Video clip is available online.Standard closure after median sternotomy reapproximates the sternum using steel wires with a simple suture technique or figure of 8 configuration (Video 1). However, this closure technique has been associated with several serious complications that have prompted surgeons to look for new closure methods. These complications include sternal instability, dehiscence, and mediastinitis as a result of bone nonconsolidation or bone disruption caused by steel wires. These conditions represent the major causes of morbidity and mortality after cardiac surgery. 1 Infection rates after median sternotomy vary from 0.2% to 10%, and in cases of infection, morbidity, and mortality, rates vary from 5% to 25%. 2 The incidence of postoperative complications is more frequent with the following risk factors: thoracic radiation, obesity, diabetes, osteoporosis, chronic lung disease, immunosuppression, renal failure, hypertension, advancing age, and chronic use of corticosteroids. [3][4][5][6] New strategies for the closure of median sternotomies are being sought to minimize the incidence of complications. However, an optimal technique has yet to be established. 7,8 Several alternative methods have been developed. Some are based on the anchoring of the steel wires to prevent rupture of the sternal bone. The first method, described in 1977, 9 consists of passing parasternal continuous wire suture alternately in front of and behind the costal cartilages, leaving them within the usual parasternal sutures (Figure 1, A). This technique can be simplified: the steel wires placed on both sides of the sternum, anterior, and posterior in the alternating costal cartilages, so that both ends of the wire From the a Program on General Basis of

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Internal mammary artery pseudoaneurysm following a robicsek sternal closure

Cited by 3 publications

References 0 publications

Combined Band and Plate Fixation as a New Individual Option for Patients at Risk of Sternal Complications after Cardiac Surgery: A Single-Center Experience

Combined Band and Plate Fixation as a New Individual Option for Patients at Risk of Sternal Complications after Cardiac Surgery: A Single-Center Experience

Safety and effectiveness of transcatheter embolization in the treatment of internal mammary artery injuries

Closure of the sternum with anchoring of the steel wires: Systematic review and meta-analysis

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