Greg’s Rather Comical Inquiry Into Median Sternotomy (Plus Video)

Every once-and-a-while, I receive patient email that is both curious and comical. This email, from Greg (in Oregon), qualifies as one of those special emails…

Hi Adam – My name is Greg and I bought your book a couple months ago and have been reading your blogs ever since! I have never written to you with a question before, but I have one that I would really like answered for my own peace-of-mind.

I have a bicuspid aortic valve with stenosis and regurgitation that I am told will need to be replaced possibly as soon as November of this year (that is when I am scheduled for my next EKG with my cardiologist). Thanks to your book and blogs I feel I have educated myself quite a bit in regards to what I should expect during this process, but one question that I have never seen addressed is in regards to the “breaking of the sternum”.

Breaking The Sternum via Median Stenotomy

Is the sternum really BROKEN? I just always assumed that a saw or cutting wheel of some kind was used, but all I ever hear or read is about it being broken. How do they do this? Does the surgeon and an assistant across the table make a wish first?

Honestly, the thought of this brings visions of being at the seafood market watching the young man behind the counter whack the fresh crabs on the edge of the counter to crack them open to clean them!

Also, I know the sternum is wired shut after the surgery, but does it ever truly heal 100%? My loving wife of nearly 23 years has a habit of occasionally (and only playfully, of course!) backhanding me in the chest to let me know that whatever I just did or said was inappropriate, and though she has been trying very hard to break that habit in anticipation of my upcoming surgery, I need to know that eventually she might be able to go back to her old ways, otherwise how else am I going to know when its time for me to shut-up?

:)

Thank you for your blogs, and wish me luck…this is going to be my very first time EVER in an operating room in nearly 44 years of life…as well as my first broken bone!

Greg from Gresham, Oregon

HERE IS MY RESPONSE TO GREG:

Greg,

I have to admit… That little bit about “the surgeon and assistant making a wish” before they break the patient’s sternum had me laughing out loud to the brink of tears. Your email only got better as I learned about your loving wife’s 23-year old habit of backhanding you to the chest. Thanks for those chuckles. I needed them.

But seriously… Yes, you are correct. A medical saw is used to split the sternum once the skin is retracted – no lobster crackers, no surgeon wishes. If you are really interested, here is a video that illustrates a median sternotomy. FYI, It’s a little graphic and bloody.

As for your question about whether or not you are ever truly healed, I’d say I’m about 98% recovered. Every once and a while I still have some aches and pains. So, point being, I imagine your wife will be backhanding you, once again, sometime after your recovery.

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.

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  • Cindy Tarver

    I LOVE the making a wish part too!! I’ve wondered myself about just how this procedure is done, but not sure I’m up to seeing the video! Thanks for the laugh ;)

  • Vicki M

    Hi Greg, I am 4 weeks post cracking. I have had very little pain in my sternum. Now that I am doing cardiac rehab and driving a little, I feel a slight discomfort. FYI, last fall I was in a car accident and cracked my sternum. That was much more painful because it was not a controlled situation and I wasn’t wired back together like I was for my surgery. Something else to laugh at, my sister kept telling everyone that I broke by scrotum. I don’t think so!

  • Greg

    Hi Cindy! I know that everyone is different in regards to what or how much they want to know or see in regards to heart…or any other type of surgery. My oldest son doesn’t even want to talk about it because it gives him the creeps! I, on the other hand want to know, learn, and see as much as possible as this helps me cope in my own way. The video really wasn’t too bad, but if you have a sensitive stomach, you might not like it. I was glad to see that it is just a nice clean cut rather than an actual “BREAK”!
    Greg

    Hi Vicki…Thanks for the reply! It is comforting to hear from someone that has been recently “cracked” and hearing that your sternum pain was (or is) minimal! I am not looking forward to ANY part of this upcoming procedure..other than the time off of work :)…but I think the sternum part is probably my biggest concern! I will be sure to talk to my surgeon pre-op and make sure he understands that under no circumstances is my scrotum to be broken!
    Greg

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