Carbon fibre-enforced stabilization system for ministernotomy resynthesis

Sternal dehiscence incidence ranges from 0.2% to 5%]. Risk factors include obesity, advanced age, use of bilateral internal thoracic arteries, diabetes mellitus and chronic obstructive pulmonary disease [1]. Traditional techniques with steel wires have been associated with dehiscence rates of up to 11.8% [2]. Utilizing titanium plates, the incidence of sternal dehiscence has reduced to 1.5% [3]. The STERN FIX Sternal Stabilization System is a biocompatible carbon-fibre reinforced poly-ether-ether-ketone tool constituting two components, both with a curved arm that embraces the sternum at the level of an intercostal space and does not perforate the intercostal fascia, reducing the retrosternal bleeding [4]. The sternal closure is performed following five steps: sizing using a gauger (device available for sternal bone thicknesses between 9.5 and 17mm); marking the selected intercostal space bilaterally to allow the passage of the device; placement of both device parts; closure of the device; and cutting the excess segment. The sternal closure is complemented with cerclage wire. The first results are very satisfactory, with 0% sternal dehiscence at 6 months on 30 patients [5], comparable to those achieved by adopting the Robicsek technique [6]. We present a video tutorial case of ministernotomy closure using the STERN FIX system.