Coral as a substitute for bone grafts in delayed sternal closure in neonates

Excerpt

A 20-day-old boy underwent open heart surgery at 9 days of age because of complex heart disease. The thorax was initially closed with a Gore-Tex patch. After 11 days, a second operation was performed for final sternal closure. The Hancock conduit was bulging out from the thoracic cavity and the sternum could not be closed without compromising cardiac output. A coralline hydroxyapatite block was interposed to enlarge the thoracic space [1]. It is a bone-like material with the strength of stone that allows vascular and bone ingrowth. The material is well tolerated by the host and leads to a stable thorax [2]. Chest radiography showed it to be of higher density than bone (Fig. 1). Thoracic CT performed 2 months later also showed the implant to be of higher density than adjacent bone, but this did not impair visualization of the mediastinal structures (Fig. 2).

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