Excision of the Clavicle for the Treatment of Sternal Nonunion Following Open Heart Surgery

(Department of Thoracic and Cardiovascular Surgery, Mie University Graduate School of Medicine, Tsu, Japan and Department of Thoracic and Cardiovascular Surgery, Yamada Red Cross Hospital*, Ise, Japan)

Yasuhiro Sawada Keizou Tanaka* Takuya Komada*
Yoshihiko Katayama* Sekira Shoumura*
A 72-year-old woman had undergone a right upper lobectomy and thoracoplasty in 1954 and an aortic valve replacement in December 2001. She suffered from dysphagia in June 2002. X-ray film and CT-scan revealed a sternal partial nonunion. The treatment was resection of the clavicle, because of the adhesion behind the sternum and the sternal partial nonunion. The postoperative course was uneventful and she was discharged. However, she was transferred to our hospital because of hematoma and bleeding at the right clavicle 1 month after the operation. Emergency operation was performed because of injury of the ramus of artery subscapularis. We ligated the ruptured portion and additionally resected the clavicle. Her postoperative course was good. Resection of the clavicle is one choice for sternal partial nonunion after open heart surgery. However, when we resect the clavicle, we should consider preservation of the ligament, reconstruction of the ligament, and the clavicular excision range.
@Jpn. J. Cardiovasc. Surg. 34: 63-66 (2005)