title: Unusual complication of sternotomy: bone fragment induced right ventricular rupture after mitral valve replacement surgery.
abstract: Major surgical complications following open cardiac procedures via median sternotomy are infrequent but potentially devastating events. We report on a unique, fatal complication of median sternotomy. A 44-year-old woman underwent mitral valve replacement for endocarditis related to intravenous drug abuse. Twenty days after the surgery, she presented to the emergency department in acute distress, and died of cardiac tamponade soon after admission. Postmortem examination revealed a defect in the right ventricular wall caused by a bone fragment resulting from the median sternotomy.
authors.affiliation: University of Maryland, School of Medicine and Office of the Chief Medical Examiner, State of Maryland, Baltimore 21201, USA.
authors.forename: T
authors.initials: T
authors.lastname: Dean
authors.forename: E
authors.initials: E
authors.lastname: Mont
authors.forename: R
authors.initials: R
authors.lastname: Kutys
authors.forename: A
authors.initials: A
authors.lastname: Burke
authors.forename: J
authors.initials: J
authors.lastname: Pestaner
mesh_terms: D000328:Adult; D001842:Bone and Bones; D004696:Endocarditis / Q000209:etiology / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D005547:Foreign Bodies; D006335:Heart Injuries / Q000209:etiology* / Q000401:mortality; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000401:mortality; D006352:Heart Ventricles / Q000293:injuries*; D006801:Humans; D008943:Mitral Valve / Q000601:surgery; D013249:Sternum / Q000601:surgery*; D015819:Substance Abuse, Intravenous / Q000150:complications*