Over 2 million people undergo sternotomy worldwide for heart surgery each year, and many develop post-sternotomy pain syndrome (PSPS) which persists in the anterior thorax. In some patients, PSPS lasts for many years or suddenly reappears a long time after the sternotomy. The exact etiology of PSPS is unknown. This article presents a case report of a patient with a diagnosis of PSPS (after card...

Median sternotomy has been a common approach for resection of bilateral pulmonary metastases. It provides good exposure and quick accessibility to most lesions in the lung. The retrocardiac left lower lobe may at times be a problematic area for resection of metastases. We have used a simultaneous median sternotomy and left video-assisted thoracoscopic approach to remove three such lesions in tw...

Background Minimally invasive aortic valve replacement (MIAVR) was first described in 1996 as an alternative to median sternotomy for AVR. Its uptake has been sporadic in cardiac surgery units in the UK. It remains unclear and somewhat controversial whether it has superior patient outcomes over conventional sternotomy. This survey aims to explore the reason for the low uptake by consultant surg...

Contemporary surgical options to remove the thymus gland include median sternotomy with extended resection or minimally invasive techniques. Transcervical thymectomy has been criticized as potentially giving a "lesser" thymectomy. We describe the trans cervical approach with telescope enhancement using a standard VATS camera. This report describes the method emphasising the excellent visualizat...

Our early experience in approaching ASD by right thoracotomy as opposed to midline sternotomy is presented. Between July 2000 and December 2001, 15 patients (group A) were operated by right thoracotomy. Mean age of patients was 8.6 years and mean weight was 31.6 kg. In the same period, midline sternotomy was used in 16 patients (group B). Mean age was 4.7 years and weight was 16.5 kg. The durat...

INTRODUCTION Degenerative aortic stenosis (AS) is the most frequent cause among aortic valve stenotic changes. Mini Sternotomy Aortic Valve Replacement is a replacement of aortic valve through upper partial sternotomy. AIM The aim of this approach is to improve postoperative convalescence by leaving pleural spaces closed and do not compromise respiratory function, to decrease bleeding, and re...

We report a 67-year-old man with a tracheostoma who successfully underwent coronary artery bypass grafting and aortic valve replacement. He had received both a tracheostoma just above the sternal notch after total laryngectomy. As the standard full sternotomy might cause mediastinitis, we performed the operation through a lower half sternotomy with a limited skin incision. Postoperatively the w...

A 73-year old lady underwent investigations into a continuous murmur 8 years after she had undergone aortic valve replacement for severe aortic stenosis. The subsequent cardiac computed tom-ography demonstrated an internal mammary arterio-venous fistula (Fig. 1). In this case, we postulate that a sternotomy wire has resulted in fistula formation. Figure 1: Branches of the internal mammary arter...