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Review
. 2014 Jul 4:2014:bcr2014204529.
doi: 10.1136/bcr-2014-204529.

Closing the cleft over a throbbing heart: neonatal sternal cleft

Ashok Raja J  1 , Mathevan G  2 , Mathiarasan K  2 , Ramasubramaniam P  1
Affiliations
Review

Closing the cleft over a throbbing heart: neonatal sternal cleft

Ashok Raja J et al. BMJ Case Rep. .

Abstract

Sternal cleft is a rare anomaly comprising 0.5% of chest wall malformations. We present a case of a neonate with a 'V'-shaped upper partial sternal cleft at birth. A hyperpigmented cutaneous nevi was present over the cleft. Primary approximation and closure of the defect was performed at 1 week of life. We discuss the presentation and management, and review the literature.

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Figures

Figure 1
Figure 1
‘V’-shaped cleft, bulging heart (arrow), hyperpigmented nevi over skin (arrow head).
Figure 2
Figure 2
CT of the chest. (A) Three-dimensional reconstruction showing increased interclavicular distance and bilateral sternal segments (short arrows); (B) Axial section showing defective sternum with intact pericardium (long arrow) and normal lung fields.
Figure 3
Figure 3
Both sternal bars (arrows) approximated to the midline with ethibond sutures.
Figure 4
Figure 4
Skin closure.
Figure 5
Figure 5
Management algorithm (USG, ultrasound sonography).
See this image and copyright information in PMC

References

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    1. Mogilner J, Siplovich L, Bar-Ziv J, et al. Surgical management of the cleft sternum. J Pediatr Surg 1988;23:889–91 - PubMed

Supplementary concepts