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Ann Thorac Surg 2004;77:1109
© 2004 The Society of Thoracic Surgeons

How to do it

T-modification of sternotomy to accommodate a low-lying tracheostomy

Kenneth J. Woodside, MDa, Joseph B. Zwischenberger, MDa, D. Adrian Olveraa, Vincent R. Conti, MDa*

a Division of Cardiothoracic Surgery, Department of Surgery, The University of Texas Medical Branch, Galveston, Texas, USA

Accepted for publication May 5, 2003.

* Address reprint requests to Dr Conti, Division of Cardiothoracic Surgery, Department of Surgery, The University of Texas Medical Branch, Galveston, TX 77555-0528, USA
e-mail: vconti{at}utmb.edu

A low-lying tracheostomy can complicate a sternotomy for coronary artery bypass grafting. A modified "T" exposure, transecting the manubrium at the first intercostal space, can be utilized to maintain sternoclavicular architecture and avoid injury to the tracheostomy at the sternal notch.






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