title: Reoperative median sternotomy using a cast spreader.
abstract: Repeat median sternotomy carries a high mortality rate secondary to a higher incidence of injury to the underlying vital structures. The reported incidence of reentry accidents may be as high as 6% to 10%. We describe a new technique of redo sternotomy using a nitrogen-powered oscillating saw and a cast spreader. The new technique was used for 89 consecutive cases without any incidence of injury to the underlying structures. The use of a case spreader during repeat median sternotomy may enhance the safety of reentry.
authors.affiliation: Department of Surgery, Baystate Medical Center, Springfield, Massachusetts 01199, USA.
authors.forename: P
authors.initials: P
authors.lastname: Kulshrestha
authors.forename: J L
authors.initials: JL
authors.lastname: Garb
authors.forename: J A
authors.initials: JA
authors.lastname: Rousou
authors.forename: R M
authors.initials: RM
authors.lastname: Engelman
authors.forename: R B
authors.initials: RB
authors.lastname: Wait
mesh_terms: D006801:Humans; D012086:Reoperation; D013249:Sternum / Q000601:surgery*; D019616:Thoracic Surgical Procedures / Q000295:instrumentation*