Figure 6 : A : The Ethibond suspension sutures have been passed through the left half of the sternal table and tied. Not shown are the sternal wires and the partial approximation of the sternum for clarity. The inset below shows the relief of the tracheal compression, anchoring of the innominate artery to the posterior aspect of the sternum and absence of the thymus in a cross-sectional view. B : Sagittal view after aortopexy showing the trans-sternal passage of suspension sutures and relief of the tracheal compression.
The partial sternotomy is closed in a standard fashion with steel wires for the partial sternotomy (Figure 7 ). The patients are typically extubated on the table. These patients are generally cared for in the ICU or the step down unit for the first 24 hours. A portable chest x ray is obtained to rule out any pneumothorax, assess the drain position and look for phrenic nerve palsy. Prophylactic antibiotics are used for 24 hours.