Sternal reconstruction using titanium plates for complicated upper hemi-sternum dehiscence

Sternal dehiscence (SD) with or without deep sternal wound infection is one of the troublesome complications of medium sternotomy. It is associated with a significant increase in post-operative morbidity and health care costs. In order to minimize the risk of SD there is a growing trend towards minimally invasive and sternal sparing approaches. Traditionally, SD is surgically managed by rewiring with or without the Robesck technique. However, this approach may not be effective in high-risk patients who are at increased risk of recurrent sternal breakdown. Recently, rigid sternal fixation using titanium plates has evolved as an alternative treatment option in the high-risk cohort. We present surgical management of a complicated upper hemi-sternal dehiscence following aortic valve replacement via upper hemi-sternotomy. We performed reconstruction of the upper hemi-sternum using titanium plates to achieve rigid sternal fixation with excellent results.