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Eur J Cardiothorac Surg 2004;25:812-818
© 2004 Elsevier Science NL

Potential risk of sternal wires

^a Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei 112, Taiwan, ROC
^b Division of Cardiovascular Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan, ROC
^c Cardiovascular Research Center, National Yang-Ming University, Taipei 112, Taiwan, ROC
^d Graduate Institute of Medical Sciences, Taipei Medical University School of Medicine, Taipei 110, Taiwan, ROC
^e Division of Cardiology, Taipei Veterans Generals Hospital, Taipei 112, Taiwan, ROC

Received 25 December 2002; received in revised form 7 August 2003; accepted 27 November 2003.

^* Corresponding author. Address: Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei 112, Taiwan, ROC. Tel.: +886-2-2875-7495; fax: +886-2-2875-7656
e-mail: ccshih{at}vghtpe.gov.tw

Objective: To understand the potential fracture mechanism of sternal wires, we collected extracted stainless steel sternal wires from patients with sternal dehiscence following open-heart operations. Surface alterations and fractured ends of sternal wires were inspected and analyzed. Methods: Eight fractured and 12 non-fractured wires extracted from five patients (closure method: figure-of-eight or straight twisted; two without and three with mediastinitis) with mean implantation interval of 13.2±4.2 days (range 8–20 days) were studied by various techniques. The extracted wires were cleaned and the fibrotic tissues were removed. Irregularities and fractured ends were assayed by scanning electron microscopy and energy dispersive X-ray analysis (EDXA). Results: All examined fractured wires showed the presence of severe transversal cracks and crevice corrosion. EDAX revealed aluminum oxide inclusion on the fractured surface. Conclusions: The synergic effect of stress and poor wire quality could be the precursors of material failure for the sternal wire.

Key Words: Fractured wire • Sternal dehiscence • Scanning electron microscopy

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