Description of a reusable device for the temporary stenting of the open sternum

BACKGROUND

Myocardial oedema, non-surgical bleeding and the use of mechanical assist devices following major heart surgery sometimes prevent primary closure of the sternum.

METHOD

We describe a reusable sterile device for temporarily stenting the open sternum for safety.

RESULTS

The sternal stent was used in 32 patients for a mean time of 2 days. We observed no mediastinitis and no wound-healing disorders. A secondary closure of the sternum was performed in 28 patients.

CONCLUSION

We present a device for sternal stenting that is reusable, easy to apply and allows a good handling of the critically ill patient due to its extreme stability.

[Cor triatriatum--a rare cause of pulmonary hemosiderosis]

Pneumological examinations including open lung biopsy performed on a male patient of 30 years of age suffering from severe respiratory distress that disabled him, as well as from massive recurring attacks of hemoptysis, resulted in suspicion of idiopathic pulmonary hemosiderosis (also known as Ceelen-Gellerstedt's syndrome). Diagnosis of cor triatriatum followed by surgery was arrived at only after a pulmonary oedema had developed and after other rare cardiac diseases had been considered. This rare congenital malformation--which occasionally becomes clinically manifest only in the adult--should be suspected in differential diagnosis of respiratory distress and a sometimes also life-threatening hemoptysis. Echocardiography is the diagnostic method of choice in this regard.

Highly acute course of ruptured papillary muscle of the tricuspid valve in a case of blunt chest trauma

The sudden onset of tricuspid insufficiency following a blunt chest trauma is extremely rare. We operated on a young woman in a state of severe shock following a riding accident, in whom complete severing of the papillary muscle of the posterior tricuspid leaflet had occurred. The valvuloplasty operation itself and the postoperative course ran smoothly, apart from a late pericardial tamponade which required surgical revision. In accordance with other reported cases we believe that traumatic tricuspid insufficiency is still a very underestimated pathological occurrence. Echocardiographic examination should therefore be regarded as an essential standard procedure in all cases of blunt chest injury.