Resternotomy Following Sternal Bone Cement Implantation: A Great Challenge for Cardiac Surgeons

Aliasghar Moeinipour¹, Alireza Sepehri Shamloo², Alireza Abdollahi Moghadam¹, Mohammad Sobhan Sheikh Andalibi², Ahmad Reza Zarifian², Hamid Hoseinikhah^1*

¹Atherosclerosis Prevention Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
²Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.

DOI: 10.4236/jbm.2015.311010                

Abstract

Background: Median sternotomy and resternotomy is the standard technique for coronary artery bypass grafting (CABG), valvular heart disease, and congenital heart disease. Despite ad-vances in many areas of cardiac surgical procedures, there is a lack of innovation in sternal closure techniques. Several studies have examined sternal closure techniques including wiring, interlocking, plate and screw, and bone cementation. However, none of them achieved widespread acceptability. On one hand, serious post-operative complications are associated with the use of wiring and plating techniques in high-risk patients. The aim of this study is showing challenges and difficulties with resternotomy in patient with a history of previous cardiac surgery and usage of biologic bone cements. Case Report: The case was a 56-year-old woman with a history of previous sternotomy for mitral and aortic valve replacement (mechanical sj. No. 29 and mechanical sj. No. 21, respectively) using biologic bone cement (Kryptonite TM, Doctors Research Group Inc.) for her osteopenic sternum. Four years after the mitral valve replacement (MVR), she was referred to emergency department with a thrombosis at the mitral valve. She under-went emergent cardiac surgery with a very difficult resternotomy under femoral cannulation support. Conclusion: Resternotomy in patients with previous sternotomy with Kryptonite bone cements or calcium phosphate cements (CPC) is safe and can be done similar to other cardiac reoperations. It seems that reoperation in this patients does not increase the risk of bleeding, morbidity, and mortality.

Keywords

Kryptonite Sternal Bone Cement, Resternotomy, Cardiac Complication

Conflicts of Interest

The authors declare no conflicts of interest.

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