How Is a Sternotomy Done?

What is a sternotomy?

A sternotomy is a surgical opening in the middle of the chest at the breastbone (sternum) to provide access to the chest cavity for heart procedures or other thoracic surgeries.

A sternotomy is a surgical incision made through the breastbone (sternum) to access the thoracic cavity. A median sternotomy is the primary approach used for major surgeries in the thoracic region, as it offers a wide view.

Median sternotomy: an incision down the midline of the entire sternum.
Hemisternotomy: an incision in the midline of half the sternum on the upper or lower part.
Clamshell sternotomy (bilateral thoracosternotomy): a partial sternotomy with a horizontal incision on both sides of the sternum in the fifth or sixth intercostal space (space between the ribs) with the ribs retracted for a wider view.
Hemiclamshell sternotomy (thoracosternotomy): a partial sternotomy with a horizontal incision on either side of the sternum in the fifth or sixth intercostal space.
Modified thoracosternotomy: a clamshell sternotomy with a modified sternal incision closure technique of the sternum with crossed wires.

Why is a median sternotomy performed?

Median sternotomy: for surgeries in the chest involving

Lungs
Heart
Esophagus
Blood vessels
The following procedures may require a median sternotomy:
Open heart surgeries such as
Heart transplant
Coronary artery bypass grafting
Corrective surgery for congenital heart defects
Lung transplant
Surgery for goiter growth in the chest region
Surgery to reconstruct the esophagus (esophagectomy)
Removal of large tumors in the thoracic cavity (mediastinal tumors)
Neurosurgical procedures in the thoracic region for treatment of
Fracture
Abnormal tissue growth (neoplasm)
Bone cysts
Bone infection (osteomyelitis)
Spinal tumors
Vertebral disc space inflammation (discitis)
Herniation of the disc’s core (nucleus pulposus)

Upper hemisternotomy: for surgeries on aortic and mitral valves.

Lower hemisternotomy: for coronary artery bypass for arteries that need approach from the lower sternum.

Emergency resternotomy: when there is hemorrhage or fluid buildup (tamponade) following a cardiac surgery.

Redo sternotomy: when the aorta or heart is adhered to the sternum.

QUESTION

In the U.S., 1 in every 4 deaths is caused by heart disease.
See Answer