title: Efficacy of thermoreactive nitinol clip implantation in reconstruction of sternal dehiscence.
abstract: BACKGROUND
  Sternal dehiscence is a severe complication of open heart surgery. Reinforced wiring, a system of reinforced sternal closure, fixation of a rigid plate, and implantation of thermoreactive nitinol clips (TRC) are some surgical procedures used. The aim of this study was to evaluate the role of TRC for secondary sternal reconstruction.
  
  
  METHODS
  Of 1198 patients who underwent their operations via median sternotomy in 2 separate medical centers, sternal dehiscence was observed in 16 patients overall (1.33%). The mean (SD) age of the patients was 64.06 ± 9.18 years (range, 40-77 years). Sternal dehiscence was diagnosed in all patients between the fifth and 30th postoperative days.
  
  
  RESULTS
  TRC were implanted in all of the patients who developed sternal dehiscence (16 patients). One patient developed severe respiratory failure, became ventilator dependent, and died from pneumonia on postoperative day 24. The other 15 patients were discharged without complications. Postoperative follow-up of the surviving patients revealed adequate and satisfactory sternal stability.
  
  
  CONCLUSIONS
  Implantation of TRC is an effective and easy method for fixing the sternum and can be performed rapidly and securely.
authors.affiliation: Department of Cardiovascular Surgery, Gülhane Military Medical Academy, Ankara, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Guler
authors.forename: Ahmet Baris
authors.initials: AB
authors.lastname: Durukan
authors.forename: Hasan Alper
authors.initials: HA
authors.lastname: Gurbuz
authors.forename: Murat
authors.initials: M
authors.lastname: Tavlasoglu
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Sahin
authors.forename: Artan
authors.initials: A
authors.lastname: Jahollari
authors.forename: Cem
authors.initials: C
authors.lastname: Yorgancioglu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Aslan
mesh_terms: D000328:Adult; D000368:Aged; D000497:Alloys; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D056346:Sternotomy / Q000009:adverse effects* / Q000379:methods; D013525:Surgical Instruments; D013529:Surgical Wound Dehiscence / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D000497:Alloys; C013616:nitinol