How Do Sternum (Sternal) Wires Work During Heart Surgery?

Although minimally invasive procedures are becoming more prevalent in the heart valve surgery community, open heart surgery via a broken sternum is still performed in most cases involving heart valve repair and heart valve replacement surgery.

That said, the sternum is “cracked” through a medical procedure known as a median sternotomy procedure. To learn more, click here.

Yes, I know…

The sound of that for a patient or a caregiver is tough to contemplate. I remember asking my cardiologist, “Ya ya ya ya mean that you’re going to crack my chest?” (That was a purposeful stutter intended to create drama by the way.)

Once you get over the fear, the reality sets. You think to yourself as you rub your chest, “Oh my gawwwwwwd. My sternum is going to be split! My surgeon is going to saw through my breast bone!”

Then comes the ultimate question, “How the heck are you going to keep my chestplate together once you fix my heart?”

Sternum Wires - Sternal Wires
Xray Of Sternum Wires After Heart Surgery

The answer to that is sternum wires (also known as sternal wires).

As a double heart valve surgery patient, I can relate to this all too well!

FYI, the picture below is me one week after surgery. Obviously there are no sternum wires to be seen. Just a nice scar that measures nine inches. (So you know, my scar is almost invisible these days. Click here for my heart valve surgery pictures.)

Heart Surgery Patient Scar Picture

Again, sternum wires (aka sternal wires) are used to close the breastbone following the surgical procedure on the heart. The chest is then closed with special internal or external stitches.

Interesting point to note… My incisional scar (on my skin) was not stitched together.  That’s right. No stitches on my incision! Instead, Dr. Vaughn Starnes used a very strong type of glue to make the skin attach.  Maybe that’s why my scar is barely visible these days.

I hope this helps explain how, at a high-level, your chestbone is re-positioned and secured following open heart surgery. Most of the time sternum wires (aka sternal wires) are used.

Keep on tickin!

Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.

To learn how Adam has helped millions of people with heart valve disease, watch Adam's video, subscribe to his free newsletter, or visit his Facebook, or Twitter pages.

  • Patti Fogel

    Thank you Adam for the VERY helpful information. My dad had what was suppose to be quad bypass yesterday (ended up being only triple) but he didn’t want to know any details. I do. Thanks so much.

    Best Regards,
    Patti Fogel

  • Dino Avradis

    Hi Adam, Thank you for all the information on your website.
    I had a triple bypass 5 months ago, everything went well except one problem with my sternum. Today I had xrays and I’ve been told that the the wires on the lower sternum are loose. I feel some crackling noise in the chest and I need to know if it is serious and if I need another rewiring procedure ? Or can I live with it without any further complications ?
    Awaiting for your reply.
    Best Regards
    Dino

  • Diane

    Thank you for your info and willingness to share. I, too, have had valve replacement. My aortic valve blew while I was in the hospital. My sternum was closed with wires. I was fortunate enough to have the best surgeon in our area. I have never felt better. It is genetic for me. Since mt surgery, I have lost a lot of weight. After readying your reports, I realize now that I had gained fluid weight. It did damage my kidneys. But I have a much better quality of life. Thank you, Adam, for sharing.

  • patricia

    had major heart surgery and have had severe chest pain 1 year later told my sternum has not closed can i put up with the pain and live with it or get rewired , I dont think I can live with the pain or wear a corset not be able to lift my children advice please

  • Jim

    Quad By-Pass for me in 3/07. BP meds were changed after surgery and I coughed excessively and months later my sternum was flexing considerably. It even seemed like it was overlapping during sleep. I asked everyone at rehab and on occasion around town. Aw it just takes time to heal most would say. By 10/08 I developed pain in my chest like something sticking me. I went to ER and they x-rayed and determined I had broken wires. I consulted with the surgeon who did the first surgery and he said easy fix. Scheduled one day surgery and after two weeks I went back for follow up. I still had lots of sternal movenment and asked surgeon what was up with that. He informed me that the surgery was cut short as the anestist hand not given me enough meds. So he only pulled the broken wires he could find. No replacements. I was much dismayed and began to search the internet for a solution and I found a company who makes sternal talons for closeure. I scheduled with another surgeon in another local on 4/29 and he considered it an emergency surgery due to the risks involved being in a non-union state. This surgeon did double wires and installed 3 sternal talons to secure my sternum. I feel solid and when I cough, sneeze or strain my chest feels fine. I am doing well and am back to enjoying life much as before the initial surgery without heart problems. Bad luck or laxluster surgery I finally got fixed after 3 surgeries. Good luck with yours patricia!

  • Carmen

    Adam,
    Thanks for all the info. you have provided to all of us. I had a heart valve replaced this past Feb. and now I feel as if my sternal wire is loose. I have back pains (the top half of my back) and when I bend down or sleep on my sides I feel as if my wire moves. I will be seeing one of my cardiologists in the near future and will ask for an ex-ray. In the meantime, is there something I should do or not do? I’ve been trying to regain upper body strength by lifting light (2, 3 lbs.) barbells but I’ve suspended that exercise recently for fear of causing myself some damage. Please respond with whatever advice you might have for me. Thanks.

  • Ray Sabb

    I had a CABG x6 19 years ago and everything well. I was 38 then. Now I am 58 and had a redo. This time CABG x5. The surgeon took the Ulna artery from my left arm, the right Internal Mammary, an artery on the bottom of my stomach and some veins from my right leg seeing the left leg was used the first time. I guess everything went ok but I am post 7, 8 weeks surgery now and still have a lot of movement in the sternum. Should not this be getting a bit tighter?

  • Jim

    Hello Ray,
    I am by no means an authority on the subject but I can speak from experience. It is my understanding that the first two weeks after surgery is when most of the healing occurs. In my case I kept the sternum stressed by lifing, coughing, etc. Therefore my sternum did not initially mend. I went back a year later for a follow up to remove broken wires and a re-wire (the wiring did not take place). I went another year before I able to locate a web site which described a RST Sternal talon. I contacted a dr. who was recommended who installs the devise in my state. I went to the dr and from there he performed the surgery. Cured my sternum problems. I am next April 3 years after the proceedure. I am solid as before the first surgery. I am very happy now and I do not fear coughing, sneezing or even lifting reasonable weight. Most MD’s consider this surgery an overkill and few use the devices, if they are even aware that they are available. Look it up for yourself and e-mail them for additional information to see if this is what you need. I am glad I did. Good Luck!

  • Susette

    Hi Adam – thank you for everything.

    My husband (53) had open heart surgery on December 16, 2011. He is wondering if/when the tightness in his chest, which is likely being caused by the sternal wires, will ever go away. What was your experience regarding that issue? Thank you.

    Susette

  • Wilbur

    My quad bypass was in November 2001. Yes, that’s over 10 years ago. I have NEVER had a feeling of movement of my sternum & since about 2-3 weeks after surgery, have felt no pain from it. Maybe it was luck & losing 50 pounds, but I think it had a lot to do with having the best surgeon that ONLY does open heart surgery. The discomfort from the incisions in my leg where the veins were taken actually gave me more trouble than my chest.

  • Bill

    I had a mitral valve repair in May this year (2012) and was told that the sternal split would be stable after 6 weeks and back to full strength after 13 weeks. It’s now 15 weeks since the surgery and my sternum is still loose and has clearly not joined together. I went back to consult my surgeon about the problem and he was extremely surprised and told me that this was a very rare occurrence as the sternum usually heals easily. In my case he said that he considered my sternum material was softer than usual and he decided that using wire would be too aggressive and he opted to use a man-made fibre thread to complete the closure. I’ve been given the option of having my sternum split again and re-fastened or learning to live with it. I’m now thinking, very reluctantly, that I’ll have to have it done again with the same surgeon but would like to know what can be done differently the next time and what assurance of success can I expect? I’m 72 y.o.

  • Cheryl Farmer

    I on the other hand want to see everything that happened to me, because I am writing a book on the experience while under and all the dreams I had, they were soooo real. Someone told me that they thought I went to Heavens door. I would like to believe that! Feel free to contact me if you wan to share any of your information to add to my book of dreams. I will be publishing it by next month.
    Talk soon
    Cheryl

  • Doug Smith

    Had aortic valve replacement and have had severe rashes and itching for 8 months. Turned out to be the sternal wires made with nickel which I am allergic to. Strangely they don’t test nickel allergies and 10% of the population has nickel allergies . Having the chest opened up to remove the wire next week . Hard to believe they don’t test. Europe using titanium wires now

  • Yvonne

    I have valve surgery when I was 5 (40 years ago !!!!). Never had any problems but in the last 3 months have had several chest infections/ coughing fits and now an abscess on my operation scar (again, never had a problem with the scar so just thought that the location of the abscess was a coincidence and not related). Am currently in the hospital as the wound has become infected so am on IV antibiotics, however the doctor I saw this morning had a theory that the wires may have come loose and that could have caused the infection/ abscess. Am awaiting tests but wondered if anyone else has had this experience ?

  • Elaine w

    I would like to ask Doug Smith how he got on. I had a triple bypass 10 maths ago. Have had problems with scar since 4 days after op. Have got blisters now on scar line. Consultant wants to remove sternum clips (going in tomorrow 5th June for this and would like to hear from anyone who has been through the same thing.

  • Louise Gwaltney

    Bill I know u posted this a couple of years back bit I was just told the same thing. But my surgeon gave me the same option to learn to live with it or go back under. Can u please tell me what happened with yours

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