[HSF] Re do after pectoralis flap

[Nasser F. Abou'Seada]

Dear John 
Interesting case. Chronic draining wound ? Chronic osteomyelitis? I presume
he had his sternum totally excised ? Is there any old operative notes? was
the pericardium closed or left open? and if closed, partially or totally?
Retro-sternal fibrosis ?? any available CT ? I'd highly consider a right
thoracotomy approach with femoro-atrial cannulation. 

NFA

From: Pigott, John D III
> Thoughts from the group: 56 y/o man after AVR 11 yrs ago.  Had chronic
draining
> wound and 18 months postop had pectoralis flap.  Now has MR.  Sternal area
feels
> firm all the way down.  How to best approach? Thanks,
> John
> 
> John Pigott