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Case Reports
. 2022 Dec;37(12):5521-5523.
doi: 10.1111/jocs.17066. Epub 2022 Oct 26.

Concomitant cardiac surgery and fixation of bilateral rib fractures sustained during cardiopulmonary resuscitation

Maria Comanici  1 , Abu Farmidi  1 , Sunil K Bhudia  1 , Vladimir Anikin  2   3
Affiliations
Case Reports

Concomitant cardiac surgery and fixation of bilateral rib fractures sustained during cardiopulmonary resuscitation

Maria Comanici et al. J Card Surg. 2022 Dec.

Abstract

Background: Chest compressions during cardiopulmonary resuscitation (CPR) may cause sternal or rib fractures and chest wall instability. This can complicate medical management and significantly impair respiratory function. Surgical management of flail chest is technically demanding, and it becomes even more challenging if the patient requires a concomitant cardiac procedure.

Case presentation: A 78-year-old male suffered a cardiac arrest and sustained sternal and bilateral rib fractures during a successful CPR. He underwent a concomitant coronary artery bypass grafting and aortic valve replacement combined with stabilization of the chest wall. We discuss the possibility of fixation of bilateral rib fractures and its role in postoperative recovery after cardiac surgery.

Conclusions: Chest wall stabilization for an already fragile patient, with impaired respiratory system performance, could help improve overall outcomes, pulmonary function, weaning from mechanical ventilation, and rehabilitation. It may be used together with a cardiac procedure for a life-threatening cardiac pathology.

Keywords: chest wall stabilization; concomitant cardiothoracic surgery; flail chest; out-of-hospital resuscitation.

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References

REFERENCES

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    1. Dehghan N, Mah JM, Schemitsch EH, Nauth A, Vicente M, McKee MD. Operative stabilization of flail chest injuries reduces mortality to that of stable chest wall injuries. J Orthop Trauma. 2018;32(1):15-21.
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