Poly-Lactic Acid Plate for Chest Wall Repair in Pentalogy of Cantrell

Abstract

The technique of using a poly-L-lactic-polyglycolic (PLLA-PGA) plate for the reconstruction of lower sternal defects is described in this chapter. In patients with pentalogy of Cantrell or inferior sternal defects causing ectopia cordis, corrective cardiac surgery and sternal reconstruction is usually performed after 2 years of age if there are minimal intracardiac defects (when the child gains more cardiovascular reserve and to allow growth of the thorax). Autologous reconstruction is recommended due to a lower risk of infection and its ability to remodel according to patient growth. However, autogenous tissue may not be adequate in patients who require surgery (eg. early corrective cardiac surgery) before 2 years of age. The PLLA-PGA plate is resorbable and can be placed during this setting. It acts as a temporary shield, obviating the use of permanent alloplastic materials. When the child is older, definitive sternal reconstruction can be performed when more reliable autologous reconstruction options are available.