A glue that rapidly bonds with bone can speed up recovery of the breastbone after surgeons intentionally break it during open-heart surgery, researchers in Calgary have found.
As part of a pilot study, cardiac surgeon Dr. Paul Fedak of Foothills Medical Centre and the University of Calgary used the adhesive polymer, called Kryptonite, on more than 20 patients.
"If we can change what people are doing to benefit patients around the world and this really does change the standard of care, then I know we've done something really significant with this work, and that would be the ultimate goal," said Fedak.
The new adhesive heals the breastbone in hours, instead of weeks, after surgery, without sticking to surrounding tissues.
Patients reported far less pain and discomfort after surgery and did not need as much strong pain medication, such as narcotics, the team found.
The ability to breathe deeply, which is known to play a key role in recovery, also substantially improved among the patients in the pilot study.
Kryptonite strengthened patient's chest
Richard Cuming of Calgary had open-heart surgery twice, first in 2007 with the traditional approach of sewing the breastbone back together with wire, and then last June with Kryptonite.
In the first operation the wire broke, Cuming's breastbone opened and he had a hard time accomplishing minor tasks such as squeezing toothpaste from a tube or turning the steering wheel of his car.
"Any time you cough or deep breath or sneeze — heaven forbid you should sneeze — you have to clutch this pillow," Cuming said of the first experience, when nurses gave him a heart-shaped pillow to aid recovery.
The second experience was "a walk in the park," in comparison. It was almost like the glue was a light that was switched on to turn off the pain, he said.
Before the second surgery, Cuming's wife, Anne, said they feared a traffic collision would send the airbag into his broken chest.
"We thought Kryptonite is actually something that kills Superman or makes him weaker. In fact, this particular bone glue makes people stronger. It's great."
Cuming's case offered a rare before-and-after chance to see the results of the glue, said Fedak.
"So here's a patient who has a completely unstable sternum. We can actually visibly see it move every time he breathes or coughs," Fedak recalled. "Then what was exciting for me was after fixing it, then I could know right away whether this product was doing what I think it could do."
By the time Cuming woke up with the glue in place, his chest was as solid as a rock, Fedak said.
The researchers have established an international study with the aim of applying the technique to more than 500 heart surgery patients over the next year or two.
More than one million open-heart surgeries are performed in the world each year by splitting the breastbone and then wiring it closed.
Regulators in Canada, the U.S. and Europe have approved the use of the product, which was developed and patented in the U.S.