Sternal "retraction": a novel application of a mandibular distractor in treating ectopia cordis with complete cleft
Michael S Gart1, Frank A Vicari
1From the *Division of Plastic and Reconstructive Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago; and †Division of Plastic and Reconstructive Surgery, Department of Surgery, Northwestern Memorial Hospital, Chicago, IL.
Abstract:
Complete thoracic ectopia cordis is associated with a uniformly dismal prognosis. The primary challenges of this disorder are (1) returning the heart to the thoracic cavity, (2) stabilizing the chest wall, and (3) repairing the sternal defect. Previously published techniques for achieving these goals have demonstrated very limited success and/or significant morbidity.We present a novel application of a mandibular distraction device as part of staged repair of this historically challenging problem. This method uses immediate stabilization and gradual "retraction" of the sternal remnants, thereby allowing physiologic compensation and avoiding the cardiorespiratory embarrassment associated with returning the heart to the thoracic cavity. Moreover, this technique allows stabilization of the associated sternal cleft and chest wall without the commonly associated morbidity of the currently available techniques.
