A sternotomy, or median sternotomy, is a procedure to create access to your heart or other body parts your breastbone protects. Your surgeon cuts through your breastbone or sternum and spreads the two sides apart to be able to see and operate on your heart. After fixing your heart, your surgeon puts the two halves of your sternum back together.
Sternotomy, also known as a median sternotomy, is a procedure to separate your sternum (breastbone). Cardiac surgeons frequently use it to access your heart and aortic arch during surgery.
Your sternum, or breastbone, is a flat, narrow bone that runs vertically (up and down) between your left and right rib cages. All of these bones are there to protect your heart and lungs, which are necessary for living. But when you have a heart problem that needs to be fixed, splitting and spreading your breastbone apart is often the best way for your surgeon to get to the area they need to reach.
An alternative to sternotomy, a mini sternotomy or upper hemisternotomy, is the most common way to reach your heart without doing a full sternotomy. A mini sternotomy uses an incision that’s only 2 to 3 inches long, which is about half the length of a traditional sternotomy. The incision starts between your breastbones and only goes down to about your fourth rib.
A median sternotomy procedure allows a surgeon the access they need to do open heart surgery. When they split your breastbone down the middle and open it, they can see and work on your heart.
Since it takes about two months for a sternotomy to heal, you can consider it major surgery. If you’re having a sternotomy, you’re most likely having open heart surgery, which is also major surgery.
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A sternotomy allows a surgeon to get to areas your sternum and ribs protect, such as your:
Some surgeries fix or remove a body part, but a sternotomy doesn’t do that. It’s an operation that allows your healthcare provider to temporarily move a bone out of the way so they can work on something under it. Most of the time, your provider needs to reach your heart through a sternotomy.
A sternotomy procedure is very common. It’s the approach cardiac surgeons use most often for coronary artery bypass surgery and other heart surgeries. Surgeons perform more than 700,000 sternotomies each year in the United States.
Before your sternotomy, your healthcare provider will:
During your sternotomy, your surgeon will:
Sternotomy wires are stainless steel wires your surgeon uses to hold the two halves of your sternum together after they complete the heart surgery. They usually don't remove the wires unless you:
Yes, sternotomy wires can break if a surgeon tightens them too much.
After your sternotomy, you’ll:
Most people can just take acetaminophen and non-steroidal medicines for pain after their sternotomy. Some people need more powerful medicine for their pain.
Advantages of a sternotomy include:
Risks of a sternotomy include:
It takes eight weeks for median sternotomy recovery. If you’re doing cardiac rehab after your heart surgery, you’ll need to limit how much you move your upper body while your sternum heals.
During your median sternotomy recovery:
You’ll also need to follow your provider’s instructions for recovery from the surgery they performed after your sternotomy.
You should be able to drive again about a month after your surgery. While your sternum is healing, you should wear a seat belt and sit in the front passenger seat. Even if they may feel uncomfortable on your chest, a seat belt and airbag will protect you during a crash.
You should have regular follow-up appointments with your healthcare provider.
After a sternotomy, you should contact your provider if your breastbone:
A note from Cleveland Clinic
Choosing the right approach for your heart surgery requires careful consideration of your situation and the procedure you’re having. Surgeons often choose a sternotomy because it’s the best way for them to see and reach your heart for certain procedures. If you have questions about a sternotomy and why it’s needed, don’t be afraid to ask your healthcare provider to explain.
Last reviewed by a Cleveland Clinic medical professional on 08/09/2022.
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