Finger Lifting Resternotomy Technique
10.4326/jjcvs.40.269
- VernacularTitle:胸骨裏面の用指挙上による再胸骨正中切開法
- Author:
Akihiko Yamauchi
;
Satoshi Muraki
;
Yasuko Miyaki
;
Kazutoshi Tachibana
;
Mayuko Uehara
;
Masaki Tabuchi
;
Tomohiro Nakajima
;
Yousuke Yanase
;
Nobuyuki Takagi
;
Tetsuya Higami
- Publication Type:Journal Article
- Keywords:
resternotomy;
cardiovascular injury;
hemorrhage
- From:Japanese Journal of Cardiovascular Surgery
2011;40(6):269-271
- CountryJapan
- Language:Japanese
-
Abstract:
We describe a novel method for repeat median sternotomy. We have successfully used ‘finger’ lifting resternotomy technique and achieved zero major cardiovascular injury/catastrophic hemorrhage events at reoperation. After general anesthesia, all patients were placed in the supine position and two external defibrillator pads were placed on the chest wall. We perform a median skin and subcutaneous incision along the previous sternotomy incision extending 3 cm distal to the sternum. The sternal wires that had been used for the previous closure were left in place but untied. Using a long electric cautery, right thoracotomy was performed under the right costal arch approach. Then, the operator could approximate the sternal wires in the retro-sternal space. At the same time, the operator could confirm the retro-sternal adhesion status which by touching with a finger. Resternotomy was performed using an oscillating saw pointed toward the operator's finger, which allowed safe re-median sternotomy from the lower to the upper part of the sternum. This technique of finger-lifting resternotomy has been employed in 50 cardiovascular reoperations and resulted in 0 incident of major cardiac injury or catastrophic hemorrhage. The finger-lifting resternotomy technique is safe and simple in reoperation procedures and yield excellent early outcomes.
