Median sternotomy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Median sternotomy is a type of surgical procedure in which a vertical inline incision is made along the sternum, after which the sternum itself is divided, or "cracked". This procedure provides access to the heart and lungs for surgical procedures such as heart transplant, corrective surgery for congenital heart defects (CHD's), or coronary artery bypass surgery.

Median sternotomy is often mistakenly referred to as open heart surgery; however, open heart involves incision of the pericardium, and many median sternotomy procedures do not require this. Open heart usually involves the use of a cardiopulmonary bypass, also known as a heart-lung machine.

Complications

Complications of median sternotomy are infrequent but are very grave. Sternal complications are seen usually in the time frame of 1-2 weeks after the surgery. They can be categorised into

• Sterile serosanguineous discharge with stable sternum
• Unstable sternum with or without sterile discharge
• Sternal dehiscence without mediastinitis
• Superficial wound infection without mediastinitis
• Subcutaneous infection, unstable sternum and
• Retrosternal extension
• Mediastinitis with or without sternal separation.

See also

• Sternal saw