Post-trauma “abrasive” right ventricular rupture without mediastinitis early post-CABG. Is the Robicsek closure technique necessary for all elderly patients?

INTRODUCTION: Right ventricular (RV) rupture with mediastinitis, is a very rare but extremely dangerous (even fatal) complication, following CABG surgery. PRESENTATION OF CASE: In this paper, we present the case of a post-trauma (after fall) RV rupture (without mediastinitis) in a patient who had undergone cardiac surgery several days ago. The cause of the rupture proved to be a broken bone piece from the lower sternal edge. DISCUSSION: RV rupture post-operatively caused by broken bone pieces or bone dislocation may occur through two mechanisms: either penetration of the RV, or through the “sandpaper effect”. In order to prevent the rupture, we should be able to recognize patients with aggravating factors (age, weight) and choose intra-operatively a suitable closure technique. CONCLUSION: We propose that the technique that could prevent such ruptures is the Robicsek technique.