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



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

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