Repair of congenital sternal cleft in infants and adolescents

Background. Clinical and surgical aspects of sternal cleft repair are presented. Primary repair in the neonatal period is the best management for this rare condition, but none of the patients in this report were referred to us during that period. Autologous repair is suitable for older patients because it avoids problems related to the implant of prosthetic materials. Methods. This article reviews 8 cases of sternal cleft not associated with ectopia cordis in patients presenting between October 1979 and November 1997. Surgical repair consisted of three sliding chondrotomies, three posterior sternal wall repairs, one combination with the Ravitch technique for pectus excavatum repair, and one posterior sternal wall repair associated with total repair of Cantrell's pentalogy. Results. All patients who submitted to surgical correction had good aesthetic and structural results. The postoperative period was uneventful except that a subcutaneous fluid collection developed in 1 patient. The mean hospital stay was 5.8 days. The patients were followed up from 4 months to 18 years. Conclusions. Whether dealing with older children or young adults, the technique of reconstructing a new sternum with a posterior periosteal nap from sternal bars and chondral grafts is a simple, quick, inexpensive, and effective option. (Ann Thorac Surg 1998;66:1151-4) (C) 1998 by The Society of Thoracic Surgeons.