Right ventricular laceration caused by sternal wire fracture following
cardiac surgery: A case report
Abstract
Resternotomy for bleeding remains a significant complication with
increased rates of morbidity and mortality. Right ventricular laceration
from fractured sternal wires is rare cause of postoperative bleeding. A
68-year-old man presented for coronary artery bypass grafting (CABG).
Postoperatively, he had a chronic obstructive pulmonary disease (COPD)
exacerbation. He initially responded to treatment, and shortly after
mobilizing, acutely decompensated hemodynamically. A bedside echo
revealed significant pericardial effusion. The patient was taken
urgently for re-exploration with a diagnosis of cardiac tamponade. All
sternal wires were fractured, and a right ventricular laceration was
identified. The laceration was repaired, and the patient recovered well
postoperatively. Postoperative hemorrhage can occur in cardiac surgical
patients, but rarely is the cause laceration secondary to sternal wire
fracture. Alternative sternal closure techniques should be considered in
this and other high-risk groups of patients. Patients with sternal
dehiscence should be monitored closely and definitive management should
not be postponed.