Our Summary
This research paper discusses a common procedure in heart surgery called median sternotomy, which involves making an incision down the middle of the chest. The paper mentions the development of minimally invasive surgery (MICS), which allows for smaller incisions and quicker recovery times. However, MICS can’t be used for all heart surgeries. The traditional median sternotomy, although less attractive in terms of appearance and infection control, is still widely used because it provides a good view of the surgical area and helps avoid complications. The paper emphasizes the importance of performing this procedure with care to avoid complications, especially when it needs to be redone.
FAQs
- What is a median sternotomy and why is it still widely used in cardiovascular surgery?
- How does the median sternotomy procedure compare to Minimally Invasive Surgery (MICS) in terms of aesthetics and infection control?
- What precautions need to be taken during a redo-sternotomy to avoid injury to the right ventricle?
Doctor’s Tip
A doctor might tell a patient who has undergone a sternotomy to avoid heavy lifting or strenuous activities for a certain period of time to prevent complications and promote proper healing. They may also advise the patient to follow a healthy diet, quit smoking, and attend follow-up appointments to monitor their recovery progress. Additionally, the doctor may recommend physical therapy or breathing exercises to help improve lung function and reduce the risk of post-operative complications.
Suitable For
Patients who are typically recommended sternotomy include those requiring open heart surgery, such as coronary artery bypass grafting, valve replacement or repair, and aortic surgery. Patients with complex cardiac conditions that cannot be addressed with minimally invasive techniques may also be recommended sternotomy. Additionally, patients who have had previous cardiac surgeries and require a redo sternotomy may also be recommended this procedure. It is important for healthcare providers to carefully assess each patient’s individual needs and consider the risks and benefits of sternotomy before recommending this procedure.
Timeline
Before sternotomy:
- Patient undergoes preoperative evaluation and preparation for surgery
- Anesthesia is administered to the patient
- Patient is positioned on the operating table
- Surgeon marks the incision site on the chest
- Surgical team sterilizes the surgical site
- Surgeon makes an incision along the sternum to access the heart and surrounding structures
After sternotomy:
- Surgeon performs the necessary cardiovascular procedure (e.g., coronary artery bypass grafting, heart valve repair/replacement)
- Patient is monitored closely in the postoperative recovery area
- Pain management and wound care are provided to the patient
- Patient begins physical therapy and rehabilitation to aid in recovery
- Patient is discharged from the hospital and continues to follow up with their healthcare team for postoperative care and monitoring.
What to Ask Your Doctor
Some questions a patient should ask their doctor about sternotomy may include:
- Why is a sternotomy recommended for my specific condition?
- What are the potential risks and complications associated with a sternotomy procedure?
- How long is the recovery process after a sternotomy?
- Are there alternative procedures or techniques that could be considered instead of a sternotomy?
- How will pain be managed after the surgery?
- What follow-up care and monitoring will be needed after a sternotomy?
- How often do complications, such as infections or right ventricle injuries, occur after a sternotomy?
- What can I do to help prevent complications or speed up the healing process after a sternotomy?
- How experienced is the surgical team in performing sternotomy procedures?
- Are there any specific instructions or precautions I should follow before and after the surgery?
Reference
Authors: Ogawa H, Fukuda H. Journal: Kyobu Geka. 2019 Sep;72(10):749-751. PMID: 31582689