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In this short video, Dr. Andrew Owens talks through and gives a few good tips for a safe redo sternotomy.
First, external defibrillator pads were placed and the patient was prepped. A discussion was had with the team as to the plan for a large bleed or ventricular injury.
The sternal wires were then cut and the horizontal oscillating saw was used to open the anterior and posterior table of the sternum. The sternum was then dissected off the heart or underlying structures. Once the heart or pericardium was off the sternum, a retractor could be safely placed.
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1 Comment
Use of the saggital saw directs the vector of force in an anterior-to-posterior fashion, right at the RV & great vessels
I’ve found that sharp dissection of the Space of Larrey under direct vision, followed by use of a craniotome is safer, the vector of force being Verticle.