Chest Surg Clin N Am. 2000 May; 10(2): 261-76.

Cleft sternum and sternal foramen.

Fokin AA.

Heineman Medical Research Laboratories, Carolinas Medical Center, Charlotte, North Carolina, USA.

Cleft sternum is a rare congenital defect of the anterior chest wall and is the result of a failed midline fusion of the sternum. Depending on the degree of separation, there are complete and incomplete forms. Its clinical significance is that it leaves the heart and great vessels unprotected. Association with craniofacial hemangiomas and omphalocele is common. Prenatal diagnosis by ultrasonography is possible. Surgical correction should be performed during the neonatal period when the direct suturing of the sternal halves is possible and the thorax can accommodate the thoracic viscera. At an older age, surgical repair is feasible, but it may require additional measures, such as sliding chondrotomies of the adjacent costal cartilages and notching of the sternal bars, to facilitate the approximation. Lung herniation at the base of the neck should be corrected by uniting the cervical muscles. The first postoperative day is the most critical because of acute reduction of the mediastinal space. Long-term results are satisfactory. Sternal foramen is a congenital oval defect at the lower third of the sternum that is asymptomatic and could be detected by CT scanning. The awareness of the anomaly is important in acupuncture practice because of the danger of heart damage.