Treatment Options

  I am one year post cabg, and the sternum has not knit back together. At least two wires holding the sternum together are broken. I have significant discomfort associated with upper body movement. Treatment options are to plate or rewire (after scraping) the sternum. What are the risks and outcomes assoicated with each procedure? Are there reasons to prefer one treatment over the other? Are there other treatment alternatives? What do you recommend?

[CCF Cardio MD - MTR]

Dear Brown, thank you for your question.  Since your sternum is probably unstable right now due to the broken sternal wires, something needs to be done.  Putting a plate in the sternum is not a common procedure and we don't have much experience with that form of treatment at the Cleveland Clinic.  I presume that if a plate is used to stabilize the sternum, it would be difficult for you to undergo another open heart surgery if your bypass grafts become occluded in the future.  Rewiring of the sternum has the potential advantage of allowing you to undergo redo surgery in the future. The risks and outcomes of each type of procedure vary greatly among institutions and according to the clinical characteristics of the patients being treated.  Thus, your cardiovascular surgeon would be better able to quote you risks and benefits.  Finally, I don't know of any other treatment alternatives.  
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.  Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart
Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.