Median sternotomy is a type of

surgical Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery ...

procedure in which a vertical inline incision is made along the

sternum The sternum (: sternums or sterna) or breastbone is a long flat bone located in the central part of the chest. It connects to the ribs via cartilage and forms the front of the rib cage, thus helping to protect the heart, lungs, and major bl ...

, after which the sternum itself is divided using a sternal saw. This procedure provides access to the heart and lungs for surgical procedures such as

heart transplant A heart transplant, or a cardiac transplant, is a surgical transplant procedure performed on patients with end-stage heart failure when other medical or surgical treatments have failed. , the most common procedure is to take a functioning heart ...

lung transplant Lung transplantation, or pulmonary transplantation, is a surgical procedure in which one or both lungs are replaced by lungs from a donor. Donor lungs can be retrieved from a living or deceased donor. A living donor can only donate one Lobes of t ...

, corrective surgery for

congenital heart defect A congenital heart defect (CHD), also known as a congenital heart anomaly, congenital cardiovascular malformation, and congenital heart disease, is a defect in the structure of the heart or great vessels that is present at birth. A congenital h ...

s, or

coronary artery bypass surgery Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced "cabbage"), is a surgical procedure to treat coronary artery disease (CAD), the buildup of plaques in the arteries of the heart. It can relieve chest ...

The median sternotomy was first proposed by Herbert M. N. Milton in 1897. Since the first successful open heart operation in 1953, most cardiac surgeons initially used the bilateral anterior

thoracotomy A thoracotomy is a surgical procedure that involves cutting open the chest wall to gain access into the pleural cavity, It is mostly performed by specialist cardiothoracic surgeons, although emergency physicians or paramedics occasionally also ...

, which was a very complication-prone and painful approach. In 1957, after the demonstration of the superiority of median sternotomy, it became the standard incision and has remained so until today. Through this approach, the surgeon can see the entire heart and control the whole operative field visually and tactically. Cardiac surgery through sternotomy is safe and efficient, and is considered to be the gold standard for surgical treatment of all congenital and acquired heart diseases resulting in low failure rates and excellent proven long-term outcomes. Cardiac surgery via median sternotomy is performed in over 1 million patients per year worldwide.

References

{{Cardiac surgery Thoracic surgical procedures Surgical incisions