Sternal pain following heart surgery

[RayW]

I am 47 years old and had a bypass operation 8 months ago after a failed angioplasty. I now have severe pain in my sternum after my surgery, especially when I take a deep breadth or raise my arm. When I raise my arm, at times I hear a clicking noise. My doctor told me I most likely have sternal non-union, or sternal dehiscence, even though he says non of the wires are broken. He thinks this happened because he used bone wax to stop the bleeding of my bone. He said the old type of bone wax is made of beeswax and that it can block bone healing. He now uses a type of wax that dissolves. My question is how long do I need to wait until I need more surgery? Do the doctors need to remove the bone with the wax to get my bone to heal?

[Cleveland Clinic]

Ray,

The technical aspects of the cardiac surgery healing process are a little beyond my area of expertise. Sternal nonunion is a difficult complication after cardiac surgery to deal with. 8 months is generally enough time for the sternal wounds to have healed, so Im not sure how much improvement you will get beyond where you are now without further intervention.  

If you were to have another procedure, it would be a procedure designed to restore stability to the sternal bony structures. I would make sure you do this with a surgeon experienced in this procedure.

good luck

[bac2]

Ray,
Unfortunately sternal healing is often a problem after CABG. The use of bone wax, which as you say is made from beeswax, is often the culprit. The issue occurs because the bleeding from the sternum needs to be stopped. Bone wax has been since the US civil war, but it is never cleared from the body and its known to stop the bone from healing, it increases infection rates and it can cause chronic inflammation and thus pain. In diabetic patients, bone wax has been associated with a 10% plus complication rate.  Some doctors have switched to a water- soluble agent called Ostene, but since this can add $40 to the cost of the operation, many hospitals are still unwilling to stock it. There are other options as well, but all interfere with bone healing and are also more expensive.
When the sternum does not heal, most cardiac surgeons work with a reconstructive plastic surgeon. Often the area where the bone wax was applied has to be excised, sine the wax is difficult to remove. Most often plates and screws are used to add stablity, and thus allow the bone to heal. The best way to solve this problem is to encourage surgeons not to use bone wax in the first place.

[sharonrae]

I had open heart surgery due to a mvp repair. My sterum was tender for a long time. I iced my sterum very well and applied cross friction massage to it  to loosen up the area. When I have x-rays of my lungs etc. I see a few wires are broken and yes, my Dr. states that Its normal. My surgery was many years ago (10 years ago) I continue to massage the area.
Good luck..................
sr

[granzs]

A related discussion, sternal non-union was started.

[john159]

A related discussion, sternum repair was started.