Abstract
Repeat sternotomy for cardiac recuperation has the risk of life-threatening hemorrhage, the result of accidentally sectioning the cardiovascular structures behind the sternum. The mortality rate of this complication is about 37% 1 Patients with ascending aortic aneurysm or right ventricle to pulmonary artery conduits are at higher risk for this complication. 2 Preoperative assessment of proximity of vascular structures to the sternum can substantially decrease the mortality rate from hemorrhage by alerting the surgeon to prepare for this complication. Frontal and lateral chest radiographs and angiography are not helpful in predicting this event. Thoracic computed tomography (CT) provides excellent anatomic evaluation of the sternum and its surrounding structures. 3 We describe the role of CT in predicting intraoperative injury to cardiovascular structures during repeat sternotorny.
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