One-stage sternal stenting with homograft bone after cardiac operation in pediatric patients

Area of Science:

• Pediatric cardiac surgery
• Thoracic reconstruction
• Biomaterials in medicine

Background:

• Low cardiac output syndrome (LCOS) is a critical complication following open heart operations in neonates and infants, associated with high mortality.
• Delayed sternal closure is a life-saving measure for LCOS but can lead to prolonged hospitalization and increased healthcare expenses.

Observation:

• The study presents a novel approach to address the challenges of delayed sternal closure in pediatric cardiac surgery.
• Two pediatric patients requiring open heart operations were treated with a modified technique.

Findings:

• A homograft bone segment was shaped and utilized as an interposition graft between the sternal edges.
• This innovative method facilitated primary sternal wound closure, avoiding the need for delayed closure in both cases.
• Midterm follow-up demonstrated satisfactory clinical outcomes for both patients.

Implications:

• This technique offers a potential alternative to delayed sternal closure, mitigating associated risks and complications.
• Shaped homograft bone interposition may improve resource utilization and reduce costs in pediatric cardiac surgery.
• Further research and larger studies are warranted to validate the long-term efficacy and broader applicability of this approach in pediatric thoracic reconstruction.