Minimally invasive parasternal approach without postoperative chest wall defect: a feasibility study

Objective To study the feasibility of the application of pedicled flap in repairing postoperative chest wall defect resulted from parasternal surgical incision. Method The study of blood Ssupply of the deeper layers of the chest wall was conducted in 10 cadavers and the distance between the lateral edge of the sternum and the internal thoracic artery in every intercostal level were measured. Based on this study, several complicated tissue naps were devised using the internal thoracic artery as pedicle. Results The internal thoracic artery was the main nutrient artery for the deeper layers of the anterior chest wall, and the distance between the sternum and the internal thoracic artery was about 1 cm, which was wide enough for the incision between these two structures The internal thoracic artery could be used as a pedicle in various tissue flaps to repair the chest wall defect after parasternal thoracotomy Conclusion It is feasible to use the internal thoracic artery as a pedicle for the tissue flap to repair the defect after parasternal thoracotomy