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Successful repair of chronic instability of anterior chest wall following right parasternal approach for closure of atrial septal defect in a young female

^a Department of Cardiothoracic Surgery Unit – I, Christian Medical College & Hospital, Vellore – 632004, Tamil Nadu, India
^b Department of Orthopaedic Surgery Unit – III, Christian Medical College & Hospital, Vellore – 632004, Tamil Nadu, India

*Corresponding author. Tel.: +91-416-2282029; fax: +91-416-2232035.

E-mail address: murugusp{at}yahoo.com (M. Sundara Pandiyan).

Chronic instability of anterior chest wall is a known complication following the minimally invasive right parasternal approach for valvular heart operations. The exact incidence of this condition, as well as the need for reoperation, has not been well documented. We report the first case of successful correction of unstable anterior chest wall in a 33-year-old lady after she underwent atrial septal defect closure through right paramedian approach eight years ago. The repair consisted of interposing iliac crest bone graft in the defect created by deficiency of the 3rd and 4th costal cartilages and anchoring the graft using steel wires.

Key Words: Minimally invasive surgery; Incisions; Chest wall; Reoperation