Publication: Straight versus S-shaped sternotomy: a histologic study in the sheep model
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Date
2014-10-01
Authors
KÜÇÜKDURMAZ, FATİH
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Abstract
Introduction: Straight sternotomy is the most common access for open heart surgery. Techniques have been
proposed for maximizing sternal stability in high-risk patients. This trend implies a growing need for newer surgical
techniques. The aim of this experimental study in the sheep model is to evaluate median vs. S shaped sternotomy
the feasibility of using a special device to accelerate the sternal instability and bone healing.
Materials and methods: We enrolled 31 sheep, weighing 18–30 kg. For all animals a midline skin incision was
made. In group I (n = 16 animals), straight median sternotomy and in group II (n = 15 animals), S-shaped incision
was marked on the periosteum of the sternum by new created device for standard S-shaped sternotomy. Sternum
biopsies were performed on second surgery month for all survived animals from the sternum and the surrounding
soft tissue.
Results: No early superficial wound complications were observed. Overall mortality in the initial approach group
was 19.3% (6 sheep). In group I; 3 sheep had died on first surgery day, the reason may be hemorrhage and in
group II; 3 sheep developed intractable VF during surgery procedure or immediately afterwards so died. There were
statistically significant differences in the scores of bone healing between group 1 and group 2 (4.2 vs.7.3, ANOVA,
p < 0.001).
Discussion: Our work is based on the use of a standard S-shaped sternotomy procedure on sheep sternum. In our
experience with the sternal healing in the sheep model, the process of new bone formation was accelerated with
S- shaped cut than straight sternotomy procedure
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KÜÇÜKDURMAZ F., -Straight versus S-shaped sternotomy: a histologic study in the sheep model-, JOURNAL OF CARDIOVASCULAR SURGERY, cilt.30, ss.173-175, 2014