Fractured sternal wire causing a cardiac laceration
Abstract Background Hemopericardium is a serious complication that can occur after cardiac surgery. While most post-operative causes are due to inflammation and bleeding, patients with broken sternal wires and an unstable sternum may develop hemopericardium from penetrating trauma. Case presentation...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-12-01
|
| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-023-02452-6 |
| _version_ | 1797397783825612800 |
|---|---|
| author | Matthew S. Khouzam Kristina Jacobsen Joseph H. Boyer Ahmad Zeeshan David Spurlock Tomer Z. Karas Jorge E. Suarez-Cavelier Daniel Rinewalt Linda Bogar Scott Silvestry George J. Palmer Kevin D. Accola Nayer Khouzam |
| author_facet | Matthew S. Khouzam Kristina Jacobsen Joseph H. Boyer Ahmad Zeeshan David Spurlock Tomer Z. Karas Jorge E. Suarez-Cavelier Daniel Rinewalt Linda Bogar Scott Silvestry George J. Palmer Kevin D. Accola Nayer Khouzam |
| author_sort | Matthew S. Khouzam |
| collection | DOAJ |
| description | Abstract Background Hemopericardium is a serious complication that can occur after cardiac surgery. While most post-operative causes are due to inflammation and bleeding, patients with broken sternal wires and an unstable sternum may develop hemopericardium from penetrating trauma. Case presentation We present the case of a 62-year-old male who underwent triple coronary bypass surgery and presented five months later with sudden anterior chest wall pain. Chest computed tomography revealed hemopericardium with an associated broken sternal wire that had penetrated into the pericardial space. The patient underwent a redo-sternotomy which revealed a 3.5 cm bleeding, jagged right ventricular laceration that correlated to the imaging findings of a fractured sternal wire projecting in the pericardial space. The laceration was repaired using interrupted 4 − 0 polypropylene sutures in horizontal mattress fashion between strips of bovine pericardium. The patient’s recovery was uneventful and he was discharged on post-operative day four without complications. Conclusion Patients with broken sternal wires and an unstable sternum require careful evaluation and management as these may have potentially life-threatening complications if left untreated. |
| first_indexed | 2024-03-09T01:16:07Z |
| format | Article |
| id | doaj.art-efaf618fb6344ce7976d10be30a71bb6 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-03-09T01:16:07Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-efaf618fb6344ce7976d10be30a71bb62023-12-10T12:31:11ZengBMCJournal of Cardiothoracic Surgery1749-80902023-12-011811510.1186/s13019-023-02452-6Fractured sternal wire causing a cardiac lacerationMatthew S. Khouzam0Kristina Jacobsen1Joseph H. Boyer2Ahmad Zeeshan3David Spurlock4Tomer Z. Karas5Jorge E. Suarez-Cavelier6Daniel Rinewalt7Linda Bogar8Scott Silvestry9George J. Palmer10Kevin D. Accola11Nayer Khouzam12Loyola University Medical Center, Stritch School of MedicineDivision of Cardiothoracic Surgery, AdventHealthDivision of Cardiothoracic Surgery, AdventHealthDivision of Cardiothoracic Surgery, AdventHealthDivision of Cardiothoracic Surgery, AdventHealthDivision of Cardiothoracic Surgery, AdventHealthDivision of Cardiothoracic Surgery, AdventHealthDivision of Cardiothoracic Surgery, AdventHealthDivision of Cardiothoracic Surgery, AdventHealthDivision of Cardiothoracic Surgery, AdventHealthDivision of Cardiothoracic Surgery, AdventHealthDivision of Cardiothoracic Surgery, AdventHealthDivision of Cardiothoracic Surgery, AdventHealthAbstract Background Hemopericardium is a serious complication that can occur after cardiac surgery. While most post-operative causes are due to inflammation and bleeding, patients with broken sternal wires and an unstable sternum may develop hemopericardium from penetrating trauma. Case presentation We present the case of a 62-year-old male who underwent triple coronary bypass surgery and presented five months later with sudden anterior chest wall pain. Chest computed tomography revealed hemopericardium with an associated broken sternal wire that had penetrated into the pericardial space. The patient underwent a redo-sternotomy which revealed a 3.5 cm bleeding, jagged right ventricular laceration that correlated to the imaging findings of a fractured sternal wire projecting in the pericardial space. The laceration was repaired using interrupted 4 − 0 polypropylene sutures in horizontal mattress fashion between strips of bovine pericardium. The patient’s recovery was uneventful and he was discharged on post-operative day four without complications. Conclusion Patients with broken sternal wires and an unstable sternum require careful evaluation and management as these may have potentially life-threatening complications if left untreated.https://doi.org/10.1186/s13019-023-02452-6HemopericardiumBroken sternal wireUnstable sternumCardiac lacerationCase-report |
| spellingShingle | Matthew S. Khouzam Kristina Jacobsen Joseph H. Boyer Ahmad Zeeshan David Spurlock Tomer Z. Karas Jorge E. Suarez-Cavelier Daniel Rinewalt Linda Bogar Scott Silvestry George J. Palmer Kevin D. Accola Nayer Khouzam Fractured sternal wire causing a cardiac laceration Journal of Cardiothoracic Surgery Hemopericardium Broken sternal wire Unstable sternum Cardiac laceration Case-report |
| title | Fractured sternal wire causing a cardiac laceration |
| title_full | Fractured sternal wire causing a cardiac laceration |
| title_fullStr | Fractured sternal wire causing a cardiac laceration |
| title_full_unstemmed | Fractured sternal wire causing a cardiac laceration |
| title_short | Fractured sternal wire causing a cardiac laceration |
| title_sort | fractured sternal wire causing a cardiac laceration |
| topic | Hemopericardium Broken sternal wire Unstable sternum Cardiac laceration Case-report |
| url | https://doi.org/10.1186/s13019-023-02452-6 |
| work_keys_str_mv | AT matthewskhouzam fracturedsternalwirecausingacardiaclaceration AT kristinajacobsen fracturedsternalwirecausingacardiaclaceration AT josephhboyer fracturedsternalwirecausingacardiaclaceration AT ahmadzeeshan fracturedsternalwirecausingacardiaclaceration AT davidspurlock fracturedsternalwirecausingacardiaclaceration AT tomerzkaras fracturedsternalwirecausingacardiaclaceration AT jorgeesuarezcavelier fracturedsternalwirecausingacardiaclaceration AT danielrinewalt fracturedsternalwirecausingacardiaclaceration AT lindabogar fracturedsternalwirecausingacardiaclaceration AT scottsilvestry fracturedsternalwirecausingacardiaclaceration AT georgejpalmer fracturedsternalwirecausingacardiaclaceration AT kevindaccola fracturedsternalwirecausingacardiaclaceration AT nayerkhouzam fracturedsternalwirecausingacardiaclaceration |