Removal of sternum after bypass surgery

DaddysGirl,

Thanks for your question. 

I have had 3 or 4 patients through the years who developed a sternal wound infection, and required the removal of the sternum.  They all had a follow-up procedure in which a flap was placed over the sternum, containing abdominal wall muscle, and sometimes underlying omentum.  This serves to protect the chest cavity from minor contact with people and objects, that most people would encounter in daily living.

You may notice that when your father breathes in, his chest/ribs will balloon out a bit, while the flap retracts in a bit.  The opposite occurs when he breathes out.  When lifting heavy objects, people usually take a breath, then hold it and exert heavy pressure by contracting their abdominal muscles.  This should be avoided by your father as this would put extra pressure on the flap. 

The walls of the cavity (ribs) will smooth out with time and should not be an issue for another tear.  In addition, the muscles of the flap will help prevent this also. 

You will need to discuss all of your questions with the surgeon, especially his future restrictions and precautions.  Wearing a vest for daily activities should not be necessary.

You should also know that all of my patients lived for several years, with no further problems related to the removal of their sternums. 

Best wishes.

Martin Cane, M.D.

here are some thoughts

http://www.steadyhealth.com/posting.php?mode=quote&p=659330

greg AKA mrbbq82

I also had a triple bypass surgery in1991 and it got infected within a week.  Back to the hospital for IV antibiotics and debreeding.   I was in the hospital for 4 months.  They took out my sternum, did the muscle flap  and a skin graft as they had debreeded so much it couldn't be closed.  I still have constant pain in my chest and back.  I can not lift more than 5 pounds and I am very caeful about being in crowds.  I can't stand anyone to touch my chest or back.  I carry a pillow in the car to put under the seat belt in front of my chest.  My doctor suggested that.  Hope your father does well,  Karen in Delaware

I can not answer your question because I am in the hospital at this time with my sternum removed and a open chest waiting for the doc to close my chest. they are going to use both of my chest  museals to do what is called adouble pectorial flap. The doc said I would lose the ability to pish an that I had to be careful not to get hit in the chest. I am wondering how painful this operation is going to be. I would not think it could be any more painfil  than it was when the doc took out my sternum. I hope you or someone could tell me how painful this is going to be?

I to had a quad by-pass in 2001 with complications. After release from hospital i was rushed back to hospital with high fever. It turned out to be an infected sternum that needed to be removed and needed a muscle flap. Unfortunately I have been inj and out of hospitals for severe constant pain. In Feb 09 they removed more of the sterum because of constant pain. Now they want to reopen me once again. with no guarantees to relief the pain. I have been on opiates, patches and morphine for all these years. I know take dilaudid 4mg every 4hrs. If i move the wrong way particularly at night I can feel these torning burning sensations. I have yet to find a doctor who has come up with a plan that will help. So I'm not sure there is a procedure that will return to me to a better life since the removal via muscle flap.

                                                                                        Dennis

MY 2007 odessey:

May 8 enter hospital short of breath and have an angiogram that shows numerous blockages

May 11 open heart surgery lasting 7 hours and comprising of five bypasses and one valve ring support

May 11 -25 Life support as the Dr's cant awake me and they tell my family that they don't know if i'll ever come out of it

May 26 fourteen days after surgery I wake up

Still unaware of my situation i am weaned from all of my IV's

I am moved to a recovery floor where a groin infection plagues me

I am then moved  to a rehab floor where upon complaining about a sore lower back a surgeon removes a cyst

June 13 my original surgeon looks at my incision and he sticks a finger in it up to his knuckle and then informs me that he is going to have to tiighten a wire holding part of my breast bone in place and so..............

June 16 i am back in surgery to tighten the wires holding my sternum and ribs in tact

I was home in July but dropped in our drive in August

Gee since then i was back in hospital with a massive infection and that resulted in them removing my sternum/breastbone in August again  i was out of it (coma) for 14 days and the family was all gathered but i pulled through and was finally out of hospital mid october

I am still off work (don't know if I even have a job) but it is GREAT to be alive

I was implanted with an ICD pace/defib in July of 2008 and am part of a study from the Ottawa Heart institute ( RAFT study) I attended a Cardiac rehab exercise pgm and continue at a  a diabetic clinic on a regular basis as well as quarterly visits to a Heart function clinic and cardiac implant clinic ...I was at a Renal clinic today ...our health care system really works when you need it here in Ontario.

I have been in touch with butterly50 and openchestman on another forum both have had radical sternectomy and have given me hope in knowing that I am not alone. If you feel the need I can provide you with more personal contact information for us ( I say us as my wife may be better able to see it from your side) I will provide you with email info and from there we can send phone numbers...I think Sharon would be great to talk to as she was there all along doing the hard work while i slept LOL

Hello my name is Anthony Nelson (56 years old) and I live in Cope SC. Your dad and I have just about the same medical problems. I just got out of the hospital after spending 5 months and 3 major operations later. I had my sternum remove due to infection and major problems with the mobility of my ribs. Every time I turn around it is like I have broken a rib then it takes a couple of weeks to get better and then I turn around and have the something but on a different rib. This has happened several times to me.

The doctors told me that due to all of my other medical problems such as diabetes, factor five Leiden gene mutation, COPD, hepatitis B, Sarcoid of my lungs, anemic, DVT's with multiple blood clots in both legs, past amputation of my right leg, 2 times I have broken the femur in my right leg two different times and just about in the same location just above my right knee, I have had chronic pain in both legs after having all of the blood clots and breaking of my femur, 

PTSD major depression with anxiety disorder just to list a few things more about my heath, and multiple ulcers on my left leg and have lost a lot of the feeling in my left leg due to diabetic neuropathy with all of the extras like pain and ulcers, hammer toes and this is not all the other medical problems I haven't listed. 

The doctors left me with my chest wide open for a long time until they felt the infection had cleared enough to perform a dual pectoral flap. This was to help fill in the large hole in my chest. No one has told me about being able to tear a hole in my heart because of my ribs being able to move. The doctors finally told me that I would not be able to do a lot of the things I use to do because of free floating ribs. All of this started after having two heart attacks and two congestive heart failures as well as telling me that the two main arteries one of them 70% blocked and the other one 100% blocked. The doctors told me that I would not make it off of the operating table if they operated.

It is bad when you're going to die if you do or die if you don't  and then that last moment after being place on a operating table waiting for the moment of dozing off and knowing your chances were nil to none. I surprised the whole hospital by making thru the operation. I will never forget the moment when I came to and opened my eyes. I guess I have run my mouth enough for now.

Please tell me how your dad tore a hole in his heart so that I could avoid that happening to me. I will tell you this if it had not been for GOD I would not be here now. Keep in touch. You know I need the same things your dad needs like some type of protection over chest to keep from getting hit or falling and hitting something on the way down I also need to know how to perform heart resuscitation without a sternum I would not want to die because of CPR so I think someone should tell us how it is done so that family members knew what to do.

Anthony Nelson

 awnelson@hughes.net

I had a sternum/ribs infection 6 weeks after my open heart surgery.  I was in the hospital for 28 days intensive care with infection.  I had debrevement every Monday for 3 weeks.  Due to the fact I am a woman they removed my sternum and filled it up with breast material.  I am still alive after 3 years and intend to live many more years. I just have a problem finding a comfortable bra with easy support.