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Ann Thorac Surg 2003;76:956-958
© 2003 The Society of Thoracic Surgeons

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Rectus abdominis myocutaneous flap after unsuccessful delayed sternal closure

Toshihiko Shibata, MDa*, Koji Hattori, MDa, Hidekazu Hirai, MDa, Hiromichi Fujii, MDa, Takanobu Aoyama, MDa, Shigefumi Seuhiro, MDa

a Department of Cardiovascular Surgery, Osaka City University Medical School, Osaka, Japan

Accepted for publication February 14, 2003.

* Address reprint requests to Dr Shibata, Department of Cardiovascular Surgery, Osaka City University Medical School, 1-4-3, Asahi-machi, Abeno, Osaka 545-8585, Japan
e-mail: shibata{at}msic.med.osaka-cu.ac.jp

Open chest management is one of the best options for severely impaired hearts after open-heart surgery. Reapproximation of sternal edges compresses the heart, so a less compressive method of chest wall reconstruction should be considered when sternal closure must be delayed. We applied a rectus abdominis myocutaneous flap approach in 3 patients after difficulties with delayed sternal closures. Two patients were weaned off intraaortic balloon pumping and survived without respiratory troubles or wound complications. This alternative method of chest reconstruction is useful in patients after an unsuccessful delayed sternal closure.




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