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Ann Thorac Surg 1991;52:569-571
© 1991 The Society of Thoracic Surgeons
a The Heart Institute for Children, Christ Hospital and Medical Center, Oak Lawn, USA
b Department of Surgery, Northwestern University Medical School, Chicago, Illinois, USA
Accepted for publication June 26, 1991.
* Address reprint requests to Dr DeLeon, Christ Hospital and Medical Center, 4440 West 95th St. Oak Lawn, IL 60453.
Twenty-two patients with valved conduits adherent to the sternum underwent resternotomy. Mean age was 10 ± 6 years, and mean conduit age was 4 ± 4 years. Diagnoses were D-transposition (7), truncus arteriosus (7), univentricular heart (6), Taussig-Bing anomaly (1), and corrected transposition (1). The majority of patients (68%) had reoperation for outgrown or degenerated conduits. In 17 patients, the sternum was opened with a chisel. Two of these patients sustained conduit neointimal collapse from manipulation, and 3 had conduit tear requiring immediate cardiopulmonary bypass through the femoral vessels. In the last 5 patients, the sternum was opened above and below the conduit, and the inner table was chiseled and left attached to the conduit avoiding injury and undue conduit manipulation. Cardiopulmonary bypass and operation were carried out uneventfully. We believe that the recent technique described provides a safe alternative approach to valved conduits adherent to the sternum.
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