Congenital Sternal Cleft with Patent Ductus Arteriosus: Report of a Case

Abstract

We report a rare case of a congenital sternal cleft. The patient was a full-term baby girl with a superior incomplete sternal cleft with patent ductus arteriosus (PDA). A primary repair of the sternum and ligation of the PDA were performed during the neonatal period without cardiac compression. Primary repair during the neonatal period is the optimal procedure for cases of congenital sternal cleft.

A Three Month-Old Girl with Cleft (Bifid) Sternum and Hemangioma of the Face

“…Because of the high flexibility of the chest wall of newborns, the primary closure is easier to perform and the risk for cardiovascular impairment is decreased (7). If the patient presents later in life, reconstruction surgery is required because a simple approximation is impossible due to increasing rigidity of the chest wall and difficulting in accomodating the heart and lungs within the chest cavity (8).…”

Bifid sternum

“…[9] Age of the patient is an important factor in determining the technique of surgical correction. [910] The optimal choice of treatment is primary direct closure in the neonatal period when flexibility of the chest wall is maximal and compression of the underlying structure is minimal. [1–358] If the patient presents later in life, reconstruction surgery is required because a simple approximation is impossible because of increasing rigidity of the chest wall and difficulty in accommodating the heart and lungs within the circumference of chest.…”

“…[1–358] If the patient presents later in life, reconstruction surgery is required because a simple approximation is impossible because of increasing rigidity of the chest wall and difficulty in accommodating the heart and lungs within the circumference of chest. [10] Various techniques have been used for the reconstruction of the chest wall. One of the earliest successful techniques was sliding costal cartilage technique by Sabiston.…”

Sternal cleft: Anaesthetic management of a rare congenital anomaly

“…[ 2 3 ] Associated anomalies, particularly cardiac anomalies, result in poor outcomes. [ 4 5 ] The surgical procedure is associated with critical changes in haemodynamics and cardiopulmonary mechanics, necessitating invasive monitoring, preparedness for cardiopulmonary bypass and resuscitation (CPR). [ 6 ] Here, we report anaesthetic management of a case of sternal cleft repair with a brief review of available literature.…”

“…Associated cardiac anomalies, defects in the anterior chest wall (ectopia cordis), or the presence of Cantrell's Pentalogy (defects involving the abdominal wall, sternum, diaphragm, pericardium and heart) indicate poor prognosis. [ 4 5 ]…”