Sterile Necrosis of the Sternum: A Rare Complication Following Coronary Artery Bypass Surgery

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Surgical Complications

Background:

• Myocardial revascularization commonly utilizes bilateral internal thoracic artery grafts.
• The Robicsek wiring technique is a standard method for sternal closure.
• Diabetes mellitus is a known risk factor for postoperative complications.

Observation:

• A 68-year-old male diabetic patient presented with sternal osteomyelitis one month post-myocardial revascularization.
• The patient had undergone sternal closure using the bilateral Robicsek wiring technique.
• The internal thoracic artery grafts were utilized bilaterally.

Findings:

• Sterile necrosis of the sternum was diagnosed.
• Surgical debridement of the necrotic sternum was performed.
• Reconstruction involved bilateral pectoralis major flaps for defect coverage.

Implications:

• This case highlights a rare complication of sternal necrosis following coronary artery bypass grafting.
• Pectoralis major flaps offer a viable reconstructive option for sternal defects.
• Awareness of this complication is crucial for managing diabetic patients undergoing sternal closure.