The purpose of this study was to determine the effect of sternotomy on transthoracic impedance, a major determinant of current flow and defibrillation success. Transthoracic impedance was determined by using a validated test-pulse technique that does not require actual shocks. Seventeen patients undergoing median sternotomy were studied prospectively. Transthoracic impedance was determined befo...

OBJECTIVES We hypothesize that minimally invasive valve surgery in patients with chronic obstructive pulmonary disease (COPD) is superior to the conventional median sternotomy approach. METHODS We retrospectively reviewed 2846 consecutive surgery performed at our institution between January 2005 and September 2010, and identified 165 patients with COPD who underwent isolated valve surgery. In...

Introduction: Approximately 2% of parathyroid adenomas reside in the mediastinum and are not amenable to the traditional cervical approach. Midline full sternotomy has been frequently used to excise these glands but this approach can be associated with significant morbidity. Methods and results: Midline partial sternotomy to the third intercostal space is a valid alternative surgical approach t...

A variety of minimally-invasive approaches for aortic valve replacement (AVR) have been developed and are increasingly being utilized. The different approaches described, such as partial upper sternotomy, right parasternal thoracotomy or transverse sternotomy have the aim to decrease invasiveness and reduce surgical trauma. Whereas port access surgery with remote cannulation has the attendant r...

PURPOSE To evaluate whether scintigraphy with technetium-99m-labeled ceftizoxime ((99m)Tc-CFT) can differentiate mediastinitis from aseptic inflammation associated with sternotomy. METHODS Twenty female Wistar rats were randomly distributed into four groups: S (control) -partial upper median sternotomy with no treatment; SW (control) - sternotomy and treatment of sternal wounds with bone wax;...

BACKGROUND There are no data comparing patient attitudes to sternotomy and thoracotomy scars following surgery for congenital heart disease (CHD). METHODS Two hundred and one patients with a scar from CHD surgery (105 sternotomy, 36 thoracotomy, and 60 both scars) had a structured interview to explore attitudes to their scar. RESULTS Comparable proportions of each group reported that they d...

PURPOSE It is critical to differentiate among pathologies of substernal thyroid gland diseases because surgical approaches (i.e., median sternotomy or thoracotomy) might also include a cervical incision. The aim of this study was to analyze the features of patients with goiter who underwent a thyroidectomy via a cervical incision and a median sternotomy or thoracotomy. METHODS We reviewed 9 c...