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Reabsorbable Pins can Reinforce an Early Sternal Stability After Median Sternotomy in Young Children with Congenital Heart Disease

Authors
  • Fan, Chengming1
  • Tang, Mi1
  • Wu, Sijie1
  • Yuan, Shuwen2
  • Borovjagin, Anton V.3
  • Yang, Jinfu1
  • 1 The Second Xiangya Hospital, Central South University, Middle Renmin Road 139, Changsha, 410011, China , Changsha (China)
  • 2 The Second Xiangya Hospital, Central South University, Changsha, China , Changsha (China)
  • 3 University of Alabama at Birmingham, Birmingham, AL, USA , Birmingham (United States)
Type
Published Article
Journal
Pediatric Cardiology
Publisher
Springer-Verlag
Publication Date
Sep 23, 2019
Volume
40
Issue
8
Pages
1728–1734
Identifiers
DOI: 10.1007/s00246-019-02212-1
Source
Springer Nature
Keywords
License
Yellow

Abstract

We evaluated the efficacy of bioresorbable sternal reinforcement device (poly-l-lactide sternal pins) on sternal healing after median sternotomy in young children (with body weight less than 10 kg) with congenital heart disease (CHD). Data from 85 patients, who underwent CHD surgery through median sternotomy from October 2016 to May 2018, were collected and analyzed. Sternal pins were utilized in 85 patients (10 mm × 1 mm × 1 mm for patients with body weights less than 5 kg and 15 mm × 2 mm × 2 mm for those weighing between 5 and 10 kg) in addition to sternum closure with Ethicon PDSTMII running sutures (Group A), while 84 patients received the Ethicon sternal closure (Group B) with no pins. The occurrence of sternal dehiscence, anterior-posterior displacement, and high-low displacement was evaluated by physical examination and three-dimensional computed tomography at one month postoperatively. No anterior-posterior sternal displacement (0%) was observed in Group A, while 10 anterior-posterior displacements (11.9%) were observed in Group B (P < 0.01). The number of sternal caudal-cranial displacements in Groups A and B was 4 (4.71%) and 5 (5.35%), respectively (P = 0.870). While no sternal dehiscence (0%) was observed in Group A, 7 out of 84 patients (8.33%) in Group B exhibited obvious sternal dehiscence (P < 0.01). The bioresorbable poly-l-lactide sternal pins reduced an anterior-posterior sternal displacement and sternal dehiscence, which was accompanied by a significant improvement of an early sternal fixation.

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