healing of sternum after bypass surgery

a dear friend in turkey wanted to come to cleveland clinic for bypass.  His doctore said too dangerous to travel.  He had it done in Istanbul over 4 months ago.  Surgery successful but sternum has not healed.  He can only sleep on his back and must carry a pillow for his chest for when he coughs.  I understand normal healing time for the sternum is 2-3 months.  He has a bad cough and complains that when he coughs it feels like his sternum is opening.  His surgeon told him he has to wait 1 year for the sternum to heal. Later, the surgeon told him that when the cough goes away, the sternum will heal.  He confirmed the doctors used stainless steel wires to secure the sternum after surgery.  He is asking what medication to take to stop the coughing.  my question is what is the correct course for him to follow now.  should he just wait for the coughing to stop and wait more for the sternum to heal or does he need to be more aggressive, seek another opinion and/or come to the usa now for treatment.

[CCF-M.D.-CRC]

Dear mataji,
When you say the sternum has not healed I assume you mean the sternum bone and not the skin wound.  If it is the skin wound this is a serious complication indicating infection and may require repeat surgery.  Bone growth on the other hand takes many months and is not generally cause for concern.  It is not uncommon for patients to complain of a 'clicking' sensation of the chest bone which may persist for quite some time.  The cough may also persist for a few weeks post-op and then usually resolves.  He should probably have a chest X-ray to make sure there is not a fluid build up in his lungs.  If he would like to be seen at the Cleveland Clinic we have a very good cardiologist here who is originally from Turkey.  His name is Dr. Murat Tuzcu and appointments can be made directly at [phone] or through the International Center at [phone] ext 46404.

[ibonzo1]

I was told that the sternum does not fully heal after open heart surgery. I was also told to avoid exercises that caused my chest muscles to pull on the sternum. Could you please clarify this issue and tell me where I can find a reliable source of advice for exercising my upper body.

[JimJa43]

I recently had an AVR.  Pre-op research, confirmed by my Doctor, indicated the Sternum should be 90-95% healed at six to seven weeks post-op.  I'm 58 years old and in my case, difficulty coughing went away at about 2-3 weeks and at nine weeks "awarnesss" behind the Sternum is only present once-in-awhile.  I began lifting very light weights, including "flies," at 2-3 weeks, two to three times per week.  At nine weeks I do three sets of 12 flies with 50 pounds of resistance with no difficulty or discomfort.  I would be VERY concerned if I was not comfortable at 12 weeks.

[welder]

I had quad bypass in june of 2000.  Since December of 2000 I have noticed a clicking and movement in the sternum area(lower).  After xray it revealed that the bottom wire had broken.  This wire was a single wrap while the others were double wrapped.  I thought this odd.  If you are experiencing this clicking you should see if the wires have broken.  Has anyone else experienced this?  How serious is this and should I be concerned.  The surgeon told me he would have to recut and rewire which is a big surgery and long recovery again.  I have put this off but I am concerned and can't seem to find any infom on line about this.  Help!!!

Nick

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