A dedicated modular system for open-chest stabilization in thoracic transplantation

Area of Science:

• Cardiovascular Surgery
• Thoracic Transplantation
• Biomedical Engineering

Background:

• Delayed chest closure is common after heart and lung transplants due to complications like graft edema and bleeding.
• Current methods use improvised spacers with mechanical and physiological limitations, potentially compromising patient stability.

Purpose of the Study:

• To design and evaluate a novel modular open-chest management system for delayed sternal closure.
• To provide controlled sternal separation, minimize mediastinal compression, and reduce direct cardiac interaction.

Main Methods:

• Development of a modular system with interchangeable plates and crossbars made from a biocompatible, fiberglass-reinforced polymer.
• Clinical application in thoracic transplant recipients requiring delayed chest closure.
• Assessment of device deployment, chest wall mechanics, ventricular filling, and imaging compatibility.

Main Results:

• The system demonstrated reproducible deployment and stable chest wall mechanics.
• Preserved ventricular filling and compatibility with postoperative imaging (MRI) were observed.
• No device-related complications occurred during initial clinical use.

Conclusions:

• The modular open-chest management system offers a standardized and physiologically consistent alternative to improvised techniques.
• This device may improve outcomes for selected thoracic transplant patients needing delayed chest closure.