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Devin J. O’Brien
Public Documents
1
Right ventricular laceration caused by sternal wire fracture following cardiac surger...
Devin J. O’Brien
and 4 more
January 31, 2024
Resternotomy for bleeding remains a significant complication with increased rates of morbidity and mortality. Right ventricular laceration from fractured sternal wires is rare cause of postoperative bleeding. A 68-year-old man presented for coronary artery bypass grafting (CABG). Postoperatively, he had a chronic obstructive pulmonary disease (COPD) exacerbation. He initially responded to treatment, and shortly after mobilizing, acutely decompensated hemodynamically. A bedside echo revealed significant pericardial effusion. The patient was taken urgently for re-exploration with a diagnosis of cardiac tamponade. All sternal wires were fractured, and a right ventricular laceration was identified. The laceration was repaired, and the patient recovered well postoperatively. Postoperative hemorrhage can occur in cardiac surgical patients, but rarely is the cause laceration secondary to sternal wire fracture. Alternative sternal closure techniques should be considered in this and other high-risk groups of patients. Patients with sternal dehiscence should be monitored closely and definitive management should not be postponed.