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Complete congenital sternal cleft associated with pectus excavatum
Alpay Sarper1, Necdet Oz, Gokhan Arslan
1Department of Thoracic Surgery, Akdeniz University, Turkey.
Texas Heart Institute Journal
|September 13, 2002
Summary
This case study details a rare congenital sternal cleft (absent sternum) and pericardial defect in a 13-year-old girl. Surgical reconstruction successfully created a sternum, offering a viable treatment for this complex condition.
Area of Science:
- Thoracic Surgery
- Congenital Malformations
- Pediatric Surgery
Background:
- Congenital sternal cleft, or absent sternum, is a rare defect where the sternum fails to close completely.
- Early surgical intervention in neonates with absent sternum is crucial due to chest wall flexibility.
- Delayed repair poses risks due to increased chest wall rigidity and organ accommodation.
Observation:
- A 13-year-old female presented with a complete congenital sternal cleft and anterior pericardial defect, unusually associated with pectus excavatum.
- The patient's age presented a unique challenge for sternal reconstruction due to chest wall rigidity.
- Surgical correction of pectus excavatum preceded sternal reconstruction.
Findings:
- A novel surgical technique was employed, involving creating flaps from sternal bars and suturing them midline.
- Nonabsorbable sutures were used to approximate the sternal bars circumferentially.
- The patient experienced an uncomplicated recovery with normal sternal appearance at 12-month follow-up.
Implications:
- This case demonstrates a successful surgical approach for late-stage sternal cleft reconstruction in an adolescent.
- The findings suggest that even in older patients, complex sternal defects can be effectively managed with tailored surgical techniques.
- This approach may improve outcomes for patients with congenital sternal clefts and associated chest wall deformities.