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Sternal approximation for bilateral anterolateral transsternal thoracotomy for lung transplantation
David C McGiffin1, Jorge E Alonso, George L Zorn
1Division of Cardiovascular and Thoracic Surgery, University of Alabama at Birmingham, Birmingham, Alabama 35294-0007, USA. david.mcgiffin@ccc.uab.edu
The Annals of Thoracic Surgery
|February 1, 2005
Summary
Peristernal cables offer a superior alternative for sternal closure after bilateral sequential lung transplantation. This method effectively prevents sternal disruption, unlike traditional wire loops, improving patient outcomes.
Area of Science:
- Cardiothoracic Surgery
- Transplantation Medicine
- Biomaterials Engineering
Background:
- Traditional sternal closure after bilateral sequential lung transplantation uses stainless steel wire loops.
- This method is linked to a high rate of sternal disruption, leading to chronic pain and deformity.
Purpose of the Study:
- To evaluate the efficacy of peristernal cable closure for sternal approximation in bilateral lung transplantation.
- To determine if peristernal cables can prevent sternal disruption and associated complications.
Main Methods:
- A novel sternal closure technique using peristernal cables passed behind the sternum and secured with crimped metal sleeves was employed.
- Forty-seven patients undergoing bilateral sequential lung transplantation received this closure method.
Main Results:
- All 47 patients achieved satisfactory bone union.
- No instances of sternal disruption were reported in the cohort.
- Cable removal was necessary in six patients for reasons including infection, cosmetic concerns, or elective procedures, with no compromise to bone union.
Conclusions:
- Peristernal cable sternal closure is a safe and effective technique for bilateral sequential lung transplantation.
- This method successfully eliminates sternal disruption, offering a significant advantage over traditional wire closure.