What is a sternotomy?
A sternotomy is a surgical procedure that makes an incision through the breastbone, or sternum, in the middle of the chest and spreads the two sides apart. This process allows your surgeon to access the heart and lungs as well as other tissues or organs in your chest that require surgery.
A thoracic surgeon or a cardiothoracic surgeon typically performs a sternotomy. It’s a standard surgical approach used when someone needs major surgery in the chest area, like for open heart surgery or transplant.
Types of sternotomy
There are a few different types of sternotomy based on the exact location and size of the incision during your surgery. A median sternotomy is used in the majority of sternotomy surgeries today. Other options include mini sternotomy and clamshell sternotomy. The type of sternotomy that’s right for you will depend on your specific condition and your treatment goals.
Why is a sternotomy performed?
A sternotomy is performed to treat serious or major medical conditions in the chest area. This type of surgery could include surgery on organs like the heart, lungs or esophagus or treatment for conditions affecting the body’s largest blood vessel—the aorta.
Some reasons you might need a sternotomy include:
- Coronary artery bypass surgery
- Heart transplant
- Congenital heart disease
- Heart valve conditions
- Lung transplant
- Lung cancer
- Mediastinal tumors
- Esophageal reconstruction
- Thymus cancer
- Aortic aneurysm
- Spine or bone conditions
Thoracotomy vs sternotomy
Thoracotomy and sternotomy are two common surgical approaches used in treating conditions in the chest. However, the types of incisions vary, and the goals are different.
The primary type of thoracotomy—called posterolateral thoracotomy—uses an incision between the ribs from the side of your chest around to your back. It is used for lung cancer treatment when minimally invasive options are not possible.
The primary type of sternotomy—called median sternotomy—uses an incision down the middle of the chest along the breastbone and is more common for cardiac surgery.
Preparing for a sternotomy
To prepare for a sternotomy, your doctor will review your health history, medications and lifestyle and give instructions on any changes you need to make to your routine before your procedure.
You’ll also have additional testing, such as blood tests or imaging tests, to make sure you are healthy enough to have a sternotomy. Because sternotomy is a major surgery, you should choose a caregiver and take steps to support a smooth recovery at home.
Be sure to follow your doctor’s specific orders to get ready for surgery, including:
- Stopping medications, such as blood thinners
- Stopping herbal medications or supplements
- Quitting smoking or stopping alcohol
- Completing pre-admission testing
- Making healthy diet and exercise choices
- Preparing your skin with an antiseptic cleanser
- Stopping food and liquids before your surgery
The sternotomy procedure
Your care team will answer your questions and tell you what to expect at every step of your sternotomy procedure. Most last several hours and your care team will keep your loved ones informed while you are in the operating room. After surgery, you can expect to stay in the hospital for seven to 10 days.
Risks and complications
Before your sternotomy, your doctor will talk with you about the procedure's goals, benefits and risks. As a major operation, sternotomy comes with some risks and potential complications. You may have risks related to the anesthesia and the surgical procedure itself. Understanding these risks and knowing what could signal a need for additional care is important.