Key Clinical Message
The fixation system consisting of a titanium plate and three pairs of claws can fix the ribs externally. This may contribute to preserve the normal thoracic structure and could result in a significant reduction in the period of ventilator dependency.
Keywords: Chest closure, descending aortic aneurysm, rib‐cross thoracotomy, thoracoabdominal aortic aneurysm
Chest closure after a descending and thoracoabdominal aortic aneurysm has rarely been discussed. After rib‐cross thoracotomy for extended thoracic aneurysm, bioabsorbable pins are usually applied to the transected ribs, and a couple of pericostal sutures are placed to fix the ribs. We experienced a rare case in which both fixed ribs were torn and laterally dislocated. The fixation system (KANI®, USCI, Tokyo, Japan) was utilized for rigid fixation. The system consists of a titanium plate (length: 37 and 53 mm; width: 16~22 mm) and three pairs of claws which could externally clamp the ribs. The patient could wean from the ventilator at the operating theater, and the 1‐year follow‐up CT showed the normal thoracic structure (Fig. 1). This may contribute to preserve the normal thoracic structure and could result in a significant reduction in the period of ventilator dependency. This fixation system could be an alternative device to close the chest after rib‐cross aortic surgery.
Figure 1.
(A) Two pairs of fixed ribs were torn and laterally dislocated after chest closure using bioabsorbable pins. (B) The titanium plate and three pairs of claws were externally clamping the ribs. A chest drainage tube was inserted. (C) The rigid fixation preserves the normal thoracic structure.
Authorship
KU, HM, and KM: performed study conception. KU and HM: collected data. KU and KM performed analysis. KU, HM, and JK performed investigation. KU: wrote manuscript. All authors: performed critical review and revision. All authors: involved final approval of the article. All authors: performed accountability for all aspects of the work.
Conflict of Interest
None declared.