The Institute of Chest Wall Surgery
Simultaneous Surgery for A One-month-old Patient with Sternal Cleft and Congenital Heart Disease
Medical History
The patient was a one-month-old infant who was discovered to have an abnormality in the anterior chest wall shortly after birth. Specifically, there was a pronounced depression in the midline of the upper chest wall where the protection of bone structures was noticeably absent. The infant was diagnosed with sternal cleft and congenital heart disease. Due to the infant's poor health, surgical intervention has been postponed temporarily. Over time, the infant's condition gradually worsened, resulting in breathing difficulties and triggering a lung infection.
Preoperative Examination
There is a noticeable depression in the center of the chest wall, accompanied by obvious paradoxical respiration. This area shows large-scale deficiency or absence of bone structures, with only about 1 cm of bone structure remaining at the inferior end of the sternum, connecting both sides of the chest wall. Additionally, the patient suffers from congenital heart diseases, including ventricular septal defect and patent foramen ovale, which have led to abnormal heart rhythms and sinus tachycardia.
Surgical Steps
1. An incision was made in the middle central region of the anterior chest wall to fully expose the heart. With the aid of cardiopulmonary bypass, surgery was performed to correct cardiac anomalies, including the ventricular septal defect and the patent foramen ovale.
2. Portions of the ribs were removed, and these fragments were used to correct the sternal cleft.
3. The defective rib area was repaired and reconstructed using MatrixRIBs.
The surgery was successfully completed in 3 hours without any complications. After the surgery, the patient’s chest wall appearance returned to normal, and abnormal breathing disappeared.
