Diminished segmentation or premature ossification of the sternum in congenital heart disease.

Bony union of the segments of the stenum starts in early childhood but is normally not complete before the 15th year of life (Ashley, 1954). We have observed early fusion or defective segmentation of the sternum in six patients with congenital heart disease and in one with a provisional diagnosis of heart disease. Subsequent search of the roentgen files of 1100 patients admitted because of suspected chest disease failed to reveal any cases of diminished segmentation but, in addition to the above-mentioned seven cases, we have seen a number of patients with less striking defective segmentation of the sternum, often in association with congenital heart disease. This group is being studied and will be the subject of a future publication. Diminished segmentation of the sternum has also been noticed in another 7 cases without detectable cardiovascular disease. In 1956, Monnet et al. described a case in which autopsy revealed partial transposition and an aberrant pulmonary vein as well as a sternal anomaly-ossificationprimaturee du sternum. Currarino et al. (1958) reported 3 examples of this condition; one patient had a large septal defect with a wide ductus arteriosus confirmed by autopsy, another had radiological evidence of an aberrant right subclavian artery, and the third had no heart disease. These authors also published seven other cases with less severe sternal anomalies, three of them with vascular deformities.