Sternum nonunion

[Gary1968]

Hi everyone, first post but really pleased I found this place.

Had a new aortic valve and aortic root replacement early September 2018. Thankfully everything went really well!

However, about two weeks after the operation I started to notice an annoying thumping sensation when ever I breathed in, although this happened when my heart beat it seemed to come from my sternum.

I told my surgeon about this and he noticed my sternum had not healed. He also said he didn’t want to carry out another operation and that eventually it would heal itself. I subsequently had a scan which showed there was still an area where my sternum had not joined back together.

I’m now seven months post op and I still get this really annoying thudding/banging. As a side effect from this I’ve noticed I don’t take a full breath in, in order to avoid the thudding sensation, as such I’m no longer fully expanding my chest when I breathe in which I’m sure isn’t healthy.

Has anybody else experienced this, if so how long did it take to clear up. Also I’ve been told a thoracic brave may help. Any views on this.

Apart from this I feel really well.

Kind regards

Gary

[Nathan53]

Hi Gary and welcome to the forum. I haven't heard anyone mention your issue - if you don't get any responses you can speak with one of the BHF specialist Nurses by calling 0300 330 3311as they may well have knowledge of this. Great that you feel well but I can imagine the thudding sensation is annoying and not good to adjust your breathing as you are.

[Gary1968 in reply to Nathan53]

Many thanks, I’ll call them tomorrow.

Kind regards

Gary

[MichaelJH Heart Star]

Although I have heard of this I have only come across it once when I was doing rehab. The guy was nine months post op. Talking with him the problem was an underlying infection of the bone. Unlike yourself he did not feel that well so infection sounds unlikely. Some people are given a special vest to wear for about six weeks after surgery and this may help to stabilise things. In some cases metal plates (usually titanium) are used to stabilise the breastbone and promote healing. Like sternal wires they would be there for life unless there was an issue of some sort.

[Gary1968 in reply to MichaelJH]

Thanks ever so much for the reply, unfortunately my surgeon and specialist don’t seem that interested. Surgeon said he just wanted me to see him in a year.

I went private with the operation for speed but the aftercare service has been shocking. Get the feeling they see me as some sort of hypochondriac! The only other issue I really seem to get other than the thumping is some difficulty inhaling. Guess it’s back to the doctors I go. Thanks again. Much appreciated.

[Recoder_Bill]

Hi Gary,

I can well empathise with where you are at.

I had a mechanical aortic valve fitted in 1995 and I should add that I also had previous surgery that meant I had no pericardium and my heart was pushed up and to left a bit. This means that my aorta was nearer my chest wall. The valve was a bi-carbon bi-leaflet valve.

I found that if I pressed on my chest at the appropriate place I could both feel and hear my valve thumping away. If I slept on my left it was also noticeable but not that much. My partner found it very comforting to listen to! … and my Godson’s brother used to love to place his hand on my chest and feel it beating.

I recovered from the operation with no problems although like you I was a bit concerned that there was some movement/creaking in my sternum but all was ok in the end.

Subsequently at the beginning of November last year I had the valve, the aortic root and the hemi-arch replaced due to the fact that I had a pseudo thoracic aortic aneurysm. The new aortic root and the hemi-arch are made of a synthetic material known as Dacron. I have yet to discover what type of mechanical aortic valve has been implanted (I’m working on it!) but what I do know is that it was integral to the aortic root.

I am pretty much recovered now but I do get the odd pain or “soreness” down the line of my “zip” from time to time but there’s no movement I can discern.

With regard to how it sounds, this valve is slightly bigger than the old valve and thumps along very noticeably! I can hear it very clearly in bed no matter how I lie. I can sometimes hear it walking around or sitting. I don’t need to feel my pulse I can count it by listening to the valve! Sometimes it’s louder than other times and my partner can hear me coming like Captain Hook could hear the crocodile!

In your situation I would insist on an appropriate scan of some sort to assess the situation. As for the “thumping”, it’s par for the course I think. It is something you get used to but I suspect that it does not necessarily indicate that there is anything wrong.

They did a CT scan, among other tests, on me at my post-op follow up and I think if there had been any sign of the sternum not healing they would have said so then.

Have you had a CT scan since the surgery? I would push hard for a scan to set your mind at rest if not.

Hope the above helps.

Regards,

Phil.