Rigid Sternal Fixation

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thos_huxley

Active member
Joined
Nov 2, 2018
Messages
25
Hi.

After an absence of several months, I briefly return to report on my AVR and my experience with rigid sternal fixation. Regarding the latter, please note that my conclusions are solely my own, and are completely anecdotal. My surgery went surprisingly well, and took only three hours to complete. An Edwards Resilia Inspira bioprosthetic was implanted (I'm 68), with the expectation that a TAVR valve-in-valve procedure will be indicated at some later date.

Because I asked for the Sternalock Blu sternal closure, I experienced an uncomplicated recovery. Very few restrictions were imposed on my post-surgery activities. I had quite good and pain-free range-of-movement: I was able to dress and bathe without special instructions (i.e., "keep your move in the tube"), could move my arms around my back freely and could use them to push up from a prone or seated position, and was able to bend over without complication. I was permitted to drive in two weeks, but I waited six. Of course, and as you might expect, coughing and sneezing were painful moments.

When I inquired about rigid fixation here before my surgery, I got an ignorant and impolite response from a well-known individual from Oz. This person appears to think the procedure is a medical oddity, practiced by only a few surgeons (the number 5 was mentioned). If the variety of published studies is any guide, rigid fixation is employed by a large number of surgeons around the world. It is demonstrated to significantly reduce sternal complications and dehisence, as well as the traditional post-operative precautions.

You needn't take my word for it. Below is a selection of research articles that indicate the value and utility of rigid fixation. While my own experience is anecdotaI, I encourage anyone here facing AVR to ask their surgeon about the use of this alternative to wire cerclage. However, in the interest of well-rounded debate, doubters can go here. Make an informed choice.

Goodbye now.


https://pubmed.ncbi.nlm.nih.gov/27923485/https://pubmed.ncbi.nlm.nih.gov/29577921/https://pubmed.ncbi.nlm.nih.gov/23103010/https://www.annalscts.com/article/view/16499/html
https://www.criticalcare.theclinics.com/action/showPdf?pii=S0749-0704(20)30045-2https://journals.lww.com/annalsplas...on_for_the_Prevention_and_Treatment_of.8.aspxhttps://www.annalsthoracicsurgery.org/article/S0003-4975(20)31894-4/fulltext#relatedArticleshttps://www.annalsthoracicsurgery.org/action/showPdf?pii=S0003-4975(18)30017-1https://www.sciencedirect.com/science/article/abs/pii/S000349751830376X
 
I have some input on this based on me asking for Rigid Sternal Fixation during my recent OHS 3 months ago.

I had my surgery at Washington DC hospital, a major cardiac hospital with great success rates. My operation was performed by an aortic specialist.

I specifically asked him about receiving rigid Sternal fixation due to all of the information provided by Dr. Mark Gerdisch

https://www.heart-valve-surgery.com/surgeons/dr-Marc-Gerdisch-Indianapolis-Indiana.php
I was specifically told by my surgeon that they tried using rigid Sternal fixation a couple years ago but the infection rate went up so they stopped and went back to the old skool way.

Not saying this for any other reason except to pass on what a good surgeon at a major hospital told me.

🤷🏻‍♂️🤷🏻‍♂️🤷🏻‍♂️
 
I can only share your experience with my post surgery recovery. I was 58 at OHS 6 years ago and came of Oxy after one day based on my wish (continued on Tylenol), had very little pain, back at work after two weeks and did my fist 30 mile bike ride 6 weeks post OHS. I attribute this also to the rigid fixation I received - also don’t understand why this is not standard procedure.
 
I can only share your experience with my post surgery recovery. I was 58 at OHS 6 years ago and came of Oxy after one day based on my wish (continued on Tylenol), had very little pain, back at work after two weeks and did my fist 30 mile bike ride 6 weeks post OHS. I attribute this also to the rigid fixation I received - also don’t understand why this is not standard procedure.

I was 50 at OHS and came off Fentanyl at 2 days. Very little pain and was released at 4 days. Back to work in 2-1/2 weeks (desk job).
 
Thanks Thomas for the information.

Timmay did Dr. Gerdisch state what was causing the infection? Medical devices are sterilized, infections can be the result of opening, implantation and closing not the device itself.
 
Thanks Thomas for the information.

Timmay did Dr. Gerdisch state what was causing the infection? Medical devices are sterilized, infections can be the result of opening, implantation and closing not the device itself.

You misunderstood what I said. Dr. Gerdisch is a fan of rigid sternal fixation. His comments are what motivated me to ask for it. My surgeon from Washington DC Hospital was the one who indicated an increase in infections. No, he did not state what was causing the infections. My guess is that he doesn’t know … just a guess though.
 
I'm just under 30 days out from aortic valve replacement and mitral valve repair with sternal plates. I'm still having some aches if I over do it to much but all in all I'm glad my surgeon went this route.
 
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