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[Re-sternotomy]

T Ban1, Y Soga

  • 1Kokura Memorial Hospital, Kitakyusyu, Japan.

Nihon Geka Gakkai Zasshi
|May 12, 1998
PubMed
Summary
This summary is machine-generated.

This review details resternotomy techniques, emphasizing careful assessment of mediastinal structures and preparation for cardiopulmonary bypass to prevent complications. It guides surgeons through sternal division and mediastinal dissection, highlighting critical steps for patient safety.

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery

Context:

  • Resternotomy, a re-entry into the chest after initial sternotomy, presents unique surgical challenges.
  • Careful preoperative assessment of mediastinal structures and potential adhesions is crucial.

Purpose:

  • To review the indications, techniques, and potential pitfalls associated with resternotomy.
  • To provide guidance on avoiding complications during resternotomy procedures.

Summary:

  • The review outlines the importance of assessing the relationship between anterior mediastinal structures and the posterior sternum using imaging (chest films, CT, tomography).
  • It details the preparation for emergency cardiopulmonary bypass, sternal division with an oscillating saw, and freeing adhered mediastinal structures.
  • Specific techniques for pericardial dissection, identification of the innominate vein, and managing cardiac or great vessel injuries are discussed, emphasizing repair under cardiopulmonary bypass when necessary.

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Impact:

  • Aims to improve surgical outcomes and reduce morbidity and mortality associated with resternotomy.
  • Provides essential knowledge for surgeons performing repeat sternotomies, enhancing patient safety.