title: Post-trauma "abrasive" right ventricular rupture without mediastinitis early post-CABG. Is the Robicsek closure technique necessary for all elderly patients?
abstract: BACKGROUND
  Right ventricular (RV) rupture with mediastinitis, is a very rare but extremely dangerous (even fatal) complication, following CABG surgery.
  
  
  METHODS
  In this paper, we present the case of a post-trauma (after fall) RV rupture (without mediastinitis) in a patient who had undergone cardiac surgery several days ago. The cause of the rupture proved to be a broken bone piece from the lower sternal edge.
  
  
  CONCLUSIONS
  RV rupture post-operatively caused by broken bone pieces or bone dislocation may occur through two mechanisms: either penetration of the RV, or through the "sandpaper effect". In order to prevent the rupture, we should be able to recognize patients with aggravating factors (age, weight) and choose intra-operatively a suitable closure technique.
  
  
  CONCLUSIONS
  We propose that the technique that could prevent such ruptures is the Robicsek technique.
authors.affiliation: Cardiac Surgery Department, Evaggelismos General Hospital, Athens, Greece.
authors.forename: Haris
authors.initials: H
authors.lastname: Georgiou
authors.affiliation: Heart and Chest Hospital, Liverpool, UK.
authors.forename: Vasileios
authors.initials: V
authors.lastname: Patris
authors.affiliation: Heart and Chest Hospital, Liverpool, UK.
authors.forename: Niki
authors.initials: N
authors.lastname: Lama
authors.affiliation: Medical School, University of Ioannina, Greece. Electronic address: orestisargiriou@yahoo.gr.
authors.forename: Orestis
authors.initials: O
authors.lastname: Argiriou
authors.affiliation: Thoracic Surgery Department, 251 General Air Force Hospital, Athens, Greece.
authors.forename: Kostas
authors.initials: K
authors.lastname: Soultanis
keywords: CABG; Right ventricular rupture; Robicsek technique; Sternal trauma