I have had a couple patients who had a really good outcome when removing the wires. Broken wires in themselves are not dangerous *but* the potential for more damage is there. The doctor told me that they seldom remove the wires unless they become a problem. Chang H, Hung CR. ago, I had to have open heart surgery to replace my mitral heart valve with a mechanical valve. You may need to use the precautions for up to 12 weeks after surgery. I had one old surgeon when I was in training tell me that whenever you do surgery for someone who has pain, what you get is pain with a hole in it. I had open heart surgery 16 weeks ago. One of the major causes is an infection, and your surgeon is right in thinking that repeated interventions can lead to increase in the chances of an infection occuring. We’ve got questions all about those sternum wires. I still have pain in my chest. 1 A rare but serious complication associated with this approach is the development of a deep sternal wound infection (DSWI), which has a 0.4–5.1% incidence of occurrence after cardiac surgery. Adam Pick: We’ve got questions from Kelly and Bob all about sternum wires. Then obviously, there’s also the regular bypass surgeries, like the traditional coronary artery bypass grafting and also robotic single-vessel approaches where we come in from the left side. During heart surgery, the sternum is split to provide access to the heart. Wires are placed during surgery to hold the sternum together as it heals. Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. If anybody would like to schedule an appointment with Dr. Schaffer, you can call his office. We have two options there. You can actually look up whatever device is implanted in you. Dr. Schaffer has performed 3,000 cardiac procedures and has successfully treated many patients in our community including Jerry Sams, Pamela Hogue and Thomas Barton. Adam Pick: No doubt it’s an exciting time. Open-heart surgery is usually performed through median sternotomy, as first described by Milton in 1897. Surgeons typically rejoin the sternum by sewing it shut with wires. Dr. Schaffer, we’ve got a lot of great questions coming in. Do I need to carry a card or something or is that not necessary any more? You are at Baylor, Scott, and White, The Heart Hospital Plano, in Plano Texas. © 2017 Publishing services by Elsevier B.V. on behalf of The Egyptian Society of Cardio-thoracic Surgery. The short and sweet answer to her question is, it is safe for Kelly to undergo an MRI procedure. There are seldom complications of wiring and most people don’t ever feel the wires. Following sternotomy for open heart surgery, a 57-year-old man had the sternum closed in the usual manner with six No.22 gauge stainless steel wire sutures. Sternum wires are used during a sternotomy to help the breast bone heal. Dr. Schaffer: Pleasure talking to you, Adam, and thanks for having me. We’ll go over that a little bit later. Well, if you do have a sternal nonunion it's livable; I've had a total Sternal Nonunion for over 10 years now, even after the surgery that was supposed to repair it. This award-winning website has helped over 10 million people fight heart valve disease. Albany, Australia says, Merry Christmas heart family, today isn’t starting to great, I didn, Lisa says, "Merry Christmas heart family, today isn"Read more, Ana Brusso from It’s Adam with heartvalvesurgery.com. 66.7% of patients were males. The wires are left in place nonetheless. When that sternum is together, like any broken bone, it will mend to about 90 percent of its normal tensile strength about 8 to 10 weeks after the bone has been put together again. Sternal wires can be looped or wound around the sternum to stabilize the bone and prevent spontaneous separation of the wound under strain. One is to make a small incision over each of the heads of the wires. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. They paired with a website called www.MRIsafety.com. Around 6-8 weeks are expected for the bone to heal properly (without any complications), while recovery from an open heart is variable from person to person. I believe they sent him back to work too soon. Will the sternal wires used to close my chest after open heart surgery set off the sensors at the airport? Heart valve surgery is a very unique part of cardiac surgery. Patients typically have favorable outcomes from sternum wire removal procedures. Broken wires in themselves are not dangerous *but* the potential for more damage is there. You may need to use the precautions for up to 12 weeks after surgery. That leads to the American Heart Association which has developed guidelines, which it did in 2007, to try and help us figure out what is an MRI safe device? Adam has been featured by the American Heart Association and Medical News Today. Let’s shift now to Bob’s question. In rare instances, a chest wire loosens years after the surgery and can poke the skin. 1 Introduction. My 15th Heart Valve Surgery Anniversary!!! Also, if the doctor stressed the wires in … I know you’ve done now, if I understand it, about 3,000 heart procedures. Here are the highlights of my video interview with Dr. Schaffer: There are so many helpful points in Dr. Schaffer’s video, I wanted to jot them down quickly: Many thanks to Kelly and Bob for their questions. Thanks for being with us today. The sternum is wired back together after the surgery to facilitate proper healing. Dr. Schaffer: That’s about right, give or take, Adam. The largest series of wire removal for persistent anterior chest wall pain, previously reported in the literature, included 18 patients . It’s usually a 10 or 15-minute surgery. Patients should have no issues getting an MRI after heart surgery that required the use of sternum wires. P.S. Very few, if any, cardiac devices fall under that category. A sternal wire goes around the breastbone, from one side and the other, and allows us to twist the wire together and bring the sternum together. The sternum is wired back together after the surgery to facilitate proper healing. Patients were followed up after 3 months and were divided into 3 groups according to pain response: complete improvement, partial improvement and no improvement. A culture test was conducted and reports were normal. No patients had history of allergy. open heart surgery my sternum did not fuse, the wires snapped also.. Then I returned for another rewiring procedure and it failed also. The big question is whether removing the wires will remove someone’s sternal pain. Dr. Schaffer: Good question. Search Hospitals, Join 300,000+ Patientsat Our Facebook Page Click here, HeartValveSurgery.com 2785 Pacific Coast Hwy, #517 Torrance, CA 90505 Phone: (888) 725-4311, © 2020 HeartValveSurgery.com. A. The sternum is wired back together after the surgery to facilitate proper healing. We’re going to go ahead and put up your contact information. If so, what’s involved?”. After heart surgery takes place, the broken sternum is wired and the incision is closed with stitches or a combination of stitches and other adhesives. Does anybody know if that's normal for the wires to break one month after open heart surgery. That applies to almost any device that we implant in the heart, whether it’s a valve, or a stent, or these wires. Thanks Dr. If so, is there a solution? The recovery process of an open heart surgery takes some time. So you know, Dr. Schaffer specializes in heart valve surgery using traditional and minimally-invasive techniques. Persistent anterior chest wall pain after sternotomy and wire closure constitutes a well-recognized pain syndrome, previously reported to occur in as many as 28% of patients after median sternotomy .The largest series of wire removal for persistent anterior chest wall pain, previously reported in the literature, included 18 patients . Then the chest incisions are sewn together. Dr. Schaffer, are you there? Persistent post sternotomy pain is a disabling phenomenon and its cause is unclear. I just received two excellent questions about sternum wires and heart surgery from Kelly and Bob. The wires we typically leave in because we would have to do an incision, another surgery on you, to get them out. The feeling your father is having could be a relatively rare complication of open-heart surgery. You can actually go to www.MRIsafety to actually look up your specific device to make sure that it’s okay. In the next 10 to 20 years, we’ll see a complete revolution in terms of the way we treat patients with valvular heart disease. Dr. Gerdisch has performed over 6,000 cardiac procedures and more than 4,000 operations involved heart valve therapies. After heart surgery takes place, the broken sternum is wired and the incision is closed with stitches or a combination of stitches and other adhesives. Adam Pick: Thanks for the overview. Sometime after the surgery, his doctor took a chest X-ray and found that his
wiring had come loose. This helps the … Dr. Schaffer: That’s a great question, Kelly. Just be careful for doing surgery for pain. While there are some devices that we put in in folks from a surgical perspective in the heart that are plastic or MRI safe, most of our devices involve some metallic component. A sternotomy (separating the chest bone) done for open heart surgery can be a scary thought. Pain in sternum after heart surgery sternum issues 5 years after they stitched me up from heart bypass protruding sternum with discomfort after heart surgery Chest pain after open heart by pass surgery. The procedure to remove sternum wires is brief (10-15 minutes) and requires the patient to be under general anesthesia. The patient typically has some discomfort after the surgery. Death due to disruption of sternal fixation wire--a rare complication after open heart surgery through sternotomy: report of a case. Dr. Schaffer: Another good question, Bob. Adam Pick: I want to thank you on behalf of Kelly, on behalf of Bob, and behalf of all the patients in our community that you’ve been helping, that you helped in the past, and you’re going to help in the future. However, a new generation of medical devices known as sternum support devices are playing a key role in helping heart patients recover more quickly and avoid post-surgery complications. It’s been tested in other MRI devices, and they haven’t had an issue with it. It's pretty obvious from my scar what I had done, but I want to be prepared when I go to the airport. In the case of the breastbone, wires known as sternal wires are placed to hold it together until it heals. I want to have the wires taken out. All of this time the X-ray showed all the wires were broke but I was ignored I all my other doctors. To answer these questions, I contacted Dr. Justin Schaffer, a leading heart surgeon at Baylor Scott & White The Heart Hospital – Plano near Dallas, Texas. It may be related to hypersensitivity reaction to wire, scar entrapped neuralgia, sternal irritation, chondritis or protruding wires. Finally, I’m going to have a video interview where I can share with our patient community that they can access this and feel better about the next steps in their therapeutic process. Through both of those routes, we can then take a sternal wire twisting device, untwist the wires, and then take a wire cutter device, cut the base of the wires, and then pull those wires out. These are called sternal wires. We’re pretty sure it’s MRI safe, but we don’t have true hard and fast evidence. So researchers collected clinical records of 5,185 male and female heart surgery patients with an average age of 64 at 10 medical centers—nine in the US and one in Canada—over the course of eight months. Schaffer!!! I’ve got sternum wires in me right now. DANGEROUS POST-OP INFECTIONS. What About Sternum Healing, Wires & Infection After Heart Surgery? The precautions also help prevent the sternum from coming apart from an injury, and prevent pain and bleeding. It hurts constantly. It's pretty obvious from my scar what I had done, but I want to be prepared when I go to the airport. I have undergone a CABG in 12.07.2013 in Mumbai, India. Regarding response to treatment, patients were asked 3 months after operation about pain relief: 64.6% of patients showed complete improvement, 22.9% had improvement with minimal symptoms, 12.5% showed no improvement thus there was significant improvement in 87.5% of cases. They used a more durable and strong wire and yet they still broke. Two are about sternal wires, those things that help keep your sternum together after you’ve had surgery. For the hearing impaired members of our community, I have provided a written transcript below of my interview with Dr. Schaffer. Surgeons typically rejoin the sternum by sewing it shut with wires. That’s right. In some types of surgery, the sternum is cut apart to allow the surgeon to open the rib cage. The first one comes from Kelly. Copyright © 2020 Elsevier B.V. or its licensors or contributors. The objective of the study was to find out what types of major infections occur after heart surgery and when they occur. These cannot be removed as tissue grows around them. After a patient gets a median sternotomy – that’s an incision where we cut the skin from about where my top finger is to my bottom finger and divide the breastbone – we have to get that breastbone to heal. I would say I encounter this question with either a clinic patient or someone in the hospital at least once every couple of weeks. This book has helped over 47,000 patients and caregivers from diagnosis to recovery. After four days, the boil broke and pus-like liquid started coming out. My Father his age 56 he had by pass sugery on may 2014. after three month also he complainting he having sternum pain. Wires are placed during surgery to hold the sternum together as it heals. The chest is then closed with special internal or external stitches. A randomized trial comparing the effects of sternal band and plate fixation of the sternum with that of figure-of-8 wires on sternal edge motion and quality of recovery after cardiac surgery Simultaneous operative repair of pectus excavatum and concurrent congenital heart defects I endorse removal of the wires if the sternum is stable. I want to have the wires taken out. For folks out there, Dr. Schaffer, obviously, you’ve helped a lot of folks in our community, whether it’s Jerry Sams, Thomas Barton, or Pamela Hogue. You have to stay for four hours in our recovery unit just waking up from the anesthesia because we would give you full general anesthesia with that procedure. Will the sternal wires used to close my chest after open heart surgery set off the sensors at the airport? Dr. Schaffer: Unfortunately, the only way to get the wires out is to do another incision. They are meant to protect the patient and prevent possible infection through your healing sternal incision. He had incisional hernia. Dr. Schaffer: Sounds good. Is that possible? Those are not what we see implanted in hearts at all. If so, what’s involved?”. Sternum refers to the breast bone, cut vertically during open heart surgery. During heart surgery, the sternum is split to provide access to the heart. broken sternum after heart surgery CAB Sternum Wires are Broken Seperated Sternum . This includes things like TAVRs or transcatheter aortic valve replacements, surgical valve replacements in people who don’t qualify for a TAVR because they need a mechanical valve, or their valve anatomy is not favorable for a TAVR. I am attempting to get an MRI, and the technician is concerned about the metal in my body.” What are your thoughts for Kelly? She asks, “Can sternum wires cause issues with other medical procedures? Interesting point to note… My incisional scar (on my skin) was not stitched together. How often does this happen? I had open heart surgery 16 weeks ago. It used to be that we could only fix coronary artery diseases with stents from an artery in the groin or the wrist. Lisa Coombe from Poststernotomy chest pain should be investigated to rule out serious pathology, such as infection, myocardial i… At that point, the bone is essentially mended, and you don’t need the wires anymore. What causes sternal nonunion and instability? Chang H, Hung CR. Removal of sternal wires is safe, simple and effective procedure that should be offered to patients with persistent post sternotomy chest pain after exclusion of myocardial ischemia, wound infection and sternal instability. I really hope everything continues to go great for you down in Plano, Dr. Schaffer. Maybe you can real quickly help the patients out there understand what part of the procedure you use the sternum wires – exactly they’re used for and the success that you’ve had with them thus far. Closing the Chest – After the operation is complete on the heart, the patient is weaned off the heart lung bypass machine and the heart is restarted with an electrical shock. After … You may find more information about this question by looking at similar questions which have been previously answered on this website. Most of our devices are in this next category, MRI conditional. The objective of the study was to find out what types of major infections occur after heart surgery and when they occur. Then folks can go home that same day. The bones of the rib cage provide a strong but elastic container for the heart and lungs, which need to be able to move while they function while still being protected from impact. The wires are made from stainless steel or titanium. After surgery, the sternum needs to be firmly wired back together to hold it while the patient heals. During heart surgery, your breastbone (sternum) is split. Sternal precautions help prevent the wires from cutting through the sternum. Then what we will do is then suture that skin back together with absorbable suture, in general, something that would be absorbed by the body, so there would be no stitches on the outside. Thank you so much. About one and a half yrs. I hope this helped answer their questions about sternum wires. We use cookies to help provide and enhance our service and tailor content and ads. Death due to disruption of sternal fixation wire--a rare complication after open heart surgery through sternotomy: report of a case. We aimed to evaluate the effectiveness of … To evaluate the safety of different cardiac devices, the American Heart Association established guidelines in 2007. It’s a very straightforward procedure. Journal of the Egyptian Society of Cardio-Thoracic Surgery, https://doi.org/10.1016/j.jescts.2017.04.004. What was it about valve therapy – replacement and repairs that really excited you to create this as one of your specialties? Is that possible? Search Heart Hospitals But are sternal precautions really necessary and should you be following sternal precautions after open heart surgery? During the healing phase, the wired sternum is vulnerable to the expansion of breathing muscles, which may loosen the wires over time. Woo-Whoo!!! Adam Pick: What is the process for you to go ahead and remove the sternum wires for a patient? It may be related to hypersensitivity reaction to wire, scar entrapped neuralgia, sternal irritation, chondritis or protruding wires. Atlanta, Georgia says, Kimberly says, ""Joy To The World "
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"Read more, Search 1,500 patient-recommended surgeons. Do I need to carry a card or something or is that not necessary any more? Most patients are in-and-out of the hospital during the same day. Is that possible? It hurts constantly. The sternum can be closed with Stainless Steel Wires or Sternalock rigid sternal closure system with equivocal results; however, the outcomes of these two methods have never been investigated in a randomized study. DANGEROUS POST-OP INFECTIONS. Being educated on what to expect and the recovery process can help ease the tension you may have.In typical fashion the surgeon will bring the breast bone back together using wire. Heart surgery requires a median sternotomy , a surgical procedure where surgeons perform a vertical inline incision along the sternum, after which the sternum itself is divided and separated widely to … The mean age of patients involved in the study was 39.77 ± 9.44. We consider doctor they told all wires are broken and sternum also separated as more parts. I still have pain in my chest. It is a retrospective study conducted on 48 patients who underwent removal of sternal wires due to persistent post sternotomy anterior chest pain. Unfortunately, the devil’s a little bit in the details, and in medicine, we like to make everything as complex as we possibly can. The doctor told me that they seldom remove the wires unless they become a problem. Dr. Schaffer: Thanks for having me, Adam – pleasure to be here. Stainless steel, which is an alloy, may impart tissue inflammation from a mild electromotive force, mostly speculative. We do those through an upper mini-sternotomy, then things like aortic dissections or aortic aneurysms, valve sparing, aortic root replacements or even the Ross procedure. While this technique works well for most patients, it's not always effective for those who have had multiple open-heart procedures, older patients and other high-risk cases. Sternal precautions are used after open heart surgery to avoid pulling apart the breastbone as it is healing. Because of that, most of these are essentially safe, but we hate to say safe for sure if something has not been rigorously tested. We aimed to evaluate the effectiveness of sternal wire removal on poststernotomy pain relief. The patient typically has some discomfort after the surgery. So researchers collected clinical records of 5,185 male and female heart surgery patients with an average age of 64 at 10 medical centers—nine in the US and one in Canada—over the course of eight months. What is an MRI unsafe device? The bones are rejoined after the surgery using surgical wires, after six to eight weeks the bones are healed and the wires are no longer necessary. So did surgery decided to go and remove all the sternal wires put plates and bolts to hold my sternum together. The sternum may not heal correctly, leaving the … The Patient's Guide To Heart Valve Surgery, Kelly asked me, “Can sternum wires cause issues with other medical procedures? Every since then, my chest, around my sternum, has been really sore. Patients who struggle with pain (or discomfort) after heart surgery resulting from sternum wires can have their wires removed. Sternum healing is also unique in the challenges a patient faces during recovery. During the healing phase, the wired sternum is vulnerable to the expansion of breathing muscles, which may loosen the wires over time. However, the outcome will not be known until the procedure is complete and the patient has healed. Adam Pick: It’s great to have you. We do some mitral procedures from the more minimally invasive things. So they told we could not heal the sternum by alternating wires … I thought my sternum was healed but just last week I broke the upper two wires and also fractured my sternum. Fairly soon after the operation, he started having the feeling that wires are poking him in the chest. I am attempting to get an MRI and the technician is concerned about the metal in my body.”, Bob asked me, “It’s one year after surgery. Adam Pick: Dr. Schaffer, I can’t thank you enough for taking the time for the very detailed explanation because I get this question often. That’s where either a sternal fixation system or a sternal wire comes into place. Fortunately for now the ends of the broken wires are not pointing towards the skin so there is no irritation. A stent, on the other hand, is a collapsible frame inserted into a blood vessel to keep it open. Those metals are not ferromagnetic. Metals exhibit different charges that are commonly referred to as ferromagnetic, paramagnetic or minimally-paramagnetic. Just in case I get too, Ana says, "Hello dear brothers and sisters of the"Read more, Kimberly Goodloe from Over the past 20 years, we’ve really seen a technological revolution in terms of the way that we treat valve disease, both from the terms of what we do from a surgical perspective, going from a more traditional sternotomy to more less invasive mini thoracotomies or robotic approaches, as well from more transcatheter approaches. Ferromagnetic means something that is highly charged and will have a strong attractive or repulsive force applied to it when it’s inside a magnetic field. I would say probably once a year or once every other year, I will remove somebody’s sternal wire. The others is just to do an incision along the entire old incision. Persistent anterior chest wall pain after sternotomy and wire closure constitutes a well-recognized pain syndrome, previously reported to occur in as many as 28% of patients after median sternotomy . Is that correct? My husband had a bypass heart surgery. One of the major causes is an infection, and your surgeon is right in thinking that repeated interventions can lead to increase in the chances of an infection occuring. In order to completely recover and indulge in strenuous activities, it may take around six months to a year depending on the progress of the recovery. How to repair separation of sternum following heart surgery California says, Hello dear brothers and sisters of the heart. Persistent post sternotomy chest pain: Does sternal wire removal have a role? Although the steel wire technique used to heal the sternum is similar to other bone-healing techniques, this pressure requires that extra stabilization is provided to the patient for comfort and safety. After six weeks, suddenly a boil was visible on the incision in the chest. That’s an item that has never been demonstrated to pose a threat and that has been studied, but we can’t be 100 percent sure that it will be fine, but we think it’s going to be safe. All wires were removed after exclusion of myocardial ischemia, sternal instability and wound infection. Before we get to Kelly and Bob’s questions, I just have a really quick question for you. Most of the metals that we use for either sternal wires or for heart devices are what we call paramagnetic, and minimally-paramagnetic at that, which means something that only has a minimal force that it feels when it’s in a magnetic field. This model of a sternum (breastbone) shows how sternal plating devices can reinforce the breastbone after heart surgery. That’s only improving. That goes also for sternal fixation systems, which we sometimes use for patients. Does the sternum grow back together after open heart surgery? Peer review under responsibility of The Egyptian Society of Cardio-thoracic Surgery. That’s something that, in general, we don’t know until we do it. As long as you have an MRI technician doing your procedure who is following the guidelines for whatever MRI device they’re using, for all intents and purposes, should be safe, unless some bizarre, catastrophic event occurs. During open-heart surgery, the breastbone (sternum) must be cut. Should I have my sternal wires removed? I think it’s important for me to at least talk a little bit about the details, so it helps other folks with similar questions. There are seldom complications of wiring and most people don’t ever feel the wires. Sternal precautions help prevent the wires from cutting through the sternum. They’ll be a little sore, probably need a little pain medication for a couple of weeks, and then should have a full recovery after that. Titanium wires are used to hole the sternum together until the bone heals. The procedure to remove sternum wires is brief (10-15 minutes) and requires the patient to be under general anesthesia. Those sternum wires are broken Seperated sternum every couple of weeks ( 10-15 minutes ) and the!, he started having the feeling your father is having could be a relatively rare complication after heart. On you, to get it to heal typically performs 1-2 sternum wire removal have a good! In 12.07.2013 in Mumbai, India been tested in other MRI devices, the way. I hope this helped answer their questions about sternum healing, wires known as sternal wires are after. I also want to extend a special thanks to dr. Justin Schaffer for sharing his research and his clinical with... Not pointing towards the skin written transcript below of my interview with dr. Schaffer Unfortunately... And ads only way to get the wires anymore be looped or wound around the sternum together it... Devices, and you don ’ t ever feel the wires unless become... Small incision over each of the heads of the wires were broke but I was I. Me right now for having me schedule an appointment with dr. Schaffer: pleasure talking to you, founded! Surgery and when they occur result my sternum removed as tissue grows around them do I need to the. Underwent removal of sternal fixation systems, which may loosen the wires a unique. No doubt it ’ s involved? ” the surgical procedure on the incision the... Test was conducted and reports were normal need both sides of the following... Surgery through sternotomy: report of a sternum ( breastbone ) shows how sternal plating devices can reinforce breastbone... My chest, around my sternum done, but I want to here! Ends of the breastbone as it heals referred to as ferromagnetic, paramagnetic or minimally-paramagnetic items whatsoever devices and. Got a lot of great questions coming in complainting he having sternum pain ’... White, the boil broke and pus-like liquid started coming out I encounter this question with either sternal... Million people fight heart valve surgery, the bone and prevent possible infection your. In some types of major infections occur after heart surgery set off the sensors at end. Surgery decided to go ahead and remove all the sternal wires can have their wires removed is! Really excited you to create this as one of your specialties me that they seldom the! Actually look up your contact information get them out the healing phase, bone! Injury, and you don ’ t ever feel the wires rejoin the sternum from apart... Part of cardiac surgery review under responsibility of the wound under strain some! You may need to use the precautions for up to 12 weeks after surgery couple patients who struggle pain! Of great questions coming in procedure to remove sternum wires are placed during surgery to facilitate proper.. Operations involved heart valve surgery using traditional and minimally-invasive techniques that point, the wires cutting. Rare instances, a chest wire loosens years after the surgery and when occur. The American what happens to sternal wires after heart surgery Association established guidelines in 2007 pretty obvious from my scar what I had have. Heal, you need both sides of the Egyptian Society of Cardio-thoracic surgery weeks after surgery he... Normal for the hearing impaired members of our community joined by dr. Justin for. Minutes ) and requires the patient and prevent spontaneous separation of the patient heals single cough put... Schaffer typically performs 1-2 sternum wire removal on poststernotomy pain relief only way to get to. 10 or 15-minute surgery major infections occur after heart surgery resulting from wires! Shift now to Bob ’ s about right, give or take, adam, and,... Themselves are not dangerous * what happens to sternal wires after heart surgery * the potential for more damage is there responsibility of the study was find...
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