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J Thorac Cardiovasc Surg 2006;132:425-426
© 2006 The American Association for Thoracic Surgery

Brief Communication

Repair of sternal dehiscence after bilateral lung transplantation

Demet Karnak, MD a , Sonia S. Shah, MD b , Maria Solovera Rozas, MD c , Sudish Murthy, MD c , Atul C. Mehta, MD b , David P. Mason, MD c , *

a Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey
b Department of Pulmonary Diseases and Critical Care Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio
c Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio

Received for publication March 1, 2006; accepted for publication March 15, 2006.

* Address for reprints: David P. Mason, MD, Surgery—Thoracic and Cardiovascular Office G2-132, 9500 Euclid Ave, Cleveland, OH 44195 (Email: masond2@ccf.org).

The first 20% of the full text of this article appears below.

Bilateral lung transplantation (BLT) is an accepted treatment for a variety of end-stage pulmonary conditions. The inframammary approach via an anterior thoracotomy and transverse sternotomy, the so-called "clam-shell" incision (CSI), is considered a preferable method for BLT owing to adequate exposure of pleural cavities, hila, and heart. The CSI is also used for heart-lung transplantation, bilateral pulmonary metastasectomy, and surgery for congenital cardiac disease. 1 Go

Transplant recipients carry a variety of comorbidities that could lead to dehiscence, nonunion, or malunion after sternotomy. 1 Go Although the terms are overlapping, "sternal dehiscence" (SDH) is defined as total disruption of surgical sutures with or without wound infection. It is also a clinical term used to describe pain, clicking sensation, and instability of the sternum. 1 Go "Nonunion" is defined as a persistent sternal fracture at least 3 months after surgery or 6 months after trauma without signs of healing or infection. 2 Go Deformed or angled healing of the sternum is referred to as "malunion," which can lead to chest wall disfigurement and pulmonary restriction, depending on its severity. Nonunion, malunion, wound . . . [Full Text of this Article]






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