Titanium plate fixation is an effective method to stabilize complicated sternal dehiscence. The longitudinal plating technique is easier to apply and seems to be associated with fewer complications.

Because our long-term follow-up in prepubescent female patients after right anterolateral thoracotomy revealed significantly impaired unilateral breast development, we propose to abandon right anterolateral thoracotomy in this subgroup of patients, although the subjective satisfaction with the cosmetic result was high. To avoid potential damage of future breast tissue, other surgical approaches, such as right posterior thoracotomy, should be considered. According to the orthopedic investigation, the surgical approach does not cause a higher rate of scoliosis.

On June 26, 2007, the Clinic for Cardiovascular Surgery at the German Heart Center Technical University in Munich successfully implanted a bioprosthetic valve via the apex of the heart within the framework of the CoreValve TAVR ReValving (Corevalve Inc., Irvine, CA, USA) clinical trial. The self-expanding aortic valve prosthesis is primarily designed for retrograde delivery across the aortic valve. The described transapical approach, however, now allows for treatment in those patients who have, for instance, no adequate "access" in the groin vessels due to peripheral vascular disease. Therefore, its feasibility must be considered as a major step in treating high-risk patients.

A 55-year-old man presented with sudden occurrence of recurrent transitoric ischemic attacks with dysphasia and paresis of the left side in May 2004. Other than these symptoms, he presented in good physical condition, with no cyanosis or edema, and his ECG showed regular sinus rhythm at normal rate. Chest x-ray and laboratory studies were unremarkable. He was not taking medication.His medical history consisted of a patent foramen ovale (PFO) that had been closed 3 years earlier with the CardioSeal/Starflex Occluder (33 mm). The PFO was diagnosed because he had presented at the hospital with headache and vertigo. The CT scan of the head showed a small anterior inferior cerebellar infarction with no evidence of tumor or bleeding. Subsequent echocardiography revealed a PFO, and the patient was referred for implantation of the atrial septal defect (ASD) closure device. The immediate postprocedural medication of our center for this device included antiplatelet therapy with aspirin 300 mg daily for 6 months. At 2-year routine follow-up, the patient was doing well, with excellent physical exercise capacity and no neurological symptoms.