Primary sternal closure and mediastinal decompression by inlay autologous rib grafts

Hemodynamic instability and arrhythmia after cardiopulmonary bypass occasionally requires delayed sternal closure or placement of a stenting device. A primary sternal closure with autologous inlay rib grafts can ensure a secure, stable sternal repair and avoids prolonged ventilator support and the concerns, risks, and expense associated with a secondary sternotomy repair.