Sternal Zipfix System
The sternal zipfix system primarily consists of polyetheretherketone (PEEK), biocompatible implants, which are similar to cable ties, and an application instrument. The purpose of this system is to achieve sternal closure following sternotomy by stabilizing the sternum and promoting fusion.
The implant itself comprises a removable stainless steel needle for peristernal application, the body with a ratchet mechanism, and a flat locking head. The application instrument is used to tension the implant, without overtensioning it, and also to cut it.
Case 1: A 66-year-old man with a history of chronic obstructive disease, obesity (BMI of 32.8), and transient ischemic attack was scheduled for a coronary artery bypass operation for stable angina.
The patients angiogram showed three-vessel coronary disease with good left ventricular function and an echocardiogram sinus rhythm.
The hybrid sternal closure technique with stainless steel wires and sternal Zipfix has been used in the authors' institution in 50 patients without any instance of sternal instability or dehiscence.
Case provided by Ted Elenbaas and Sander Wolters, Eindhoven, The Netherlands
Case 2: A 55-year-old woman, who previously underwent ventricular septal defect closure at 5 and aortic valve reconstruction at 31, required aortic valve replacement due to symptomatic aortic valve insufficiency.
The patient was morbidly obese with a BMI of 45. Due to the high risk for sternal instability and/or deep sternal wound infection, closure was performed using the sternal zipfix system. The zipfix provides quick and reliable stable fixation of the sternum even in patients that are at a higher risk to develop a sternal instability or a deep sternal wound infection.
The postoperative course was uneventful and the patient was discharged on postoperative day 7 with no signs of sternal instability or wound healing problems. At 18 months follow-up the wound had healed completely and the sternum was stable, with no signs of infection.
Case provided by Roman Gottardi, Salzburg, Austria
Median Sternotomy Closure
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