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Right ventricular laceration caused by sternal wire fracture following cardiac surgery: A case report
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  • Devin J. O’Brien,
  • Abdullah Baghaffar,
  • Ryaan EL-Andari,
  • Claudio DiQuinzio,
  • Ali Idris
Devin J. O’Brien
University of Alberta Department of Surgery
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Abdullah Baghaffar
University of Alberta Department of Surgery
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Ryaan EL-Andari
University of Alberta Faculty of Medicine & Dentistry

Corresponding Author:elandari@ualberta.ca

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Claudio DiQuinzio
Dalhousie University Division of Cardiac Surgery
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Ali Idris
Dalhousie University Division of Cardiac Surgery
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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.