title: Anterior sternal retraction for reoperative median sternotomy.
abstract: The incidence of reoperative median sternotomy for repeat cardiac surgery is increasing. Reoperative median sternotomy is associated with a higher morbidity and mortality than first-time cardiac surgery. A portion of this morbidity and mortality may be due to direct injury to the heart and great vessels in the process of reopening the sternum. We report a new technique utilizing anterior sternal retraction that allows division of adhesions between the undersurface of the sternum and the heart and great vessels under direct vision. This technique enables the surgeon to minimize the risk of serious injury to these underlying structures during reoperative cardiac surgery.
authors.affiliation: Department of Surgery, University of Washington, Seattle 98195.
authors.forename: A C
authors.initials: AC
authors.lastname: Eddy
authors.forename: D
authors.initials: D
authors.lastname: Miller
authors.forename: D
authors.initials: D
authors.lastname: Johnson
authors.forename: D
authors.initials: D
authors.lastname: Gartman
authors.forename: M
authors.initials: M
authors.lastname: Gregg
authors.forename: M
authors.initials: M
authors.lastname: Allen
authors.forename: E D
authors.initials: ED
authors.lastname: Verrier
mesh_terms: D006348:Cardiac Surgical Procedures; D006801:Humans; D007431:Intraoperative Complications; D008722:Methods; D012086:Reoperation; D013249:Sternum / Q000601:surgery*; D013523:Surgical Equipment