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.