Superior sternal cleft repair using autologous rib grafts in an infant with complex congenital heart disease.

We report the case of an infant with superior cleft sternum and obstructed type III (infra-diaphragmatic) total anomalous pulmonary venous return. A previously undescribed approach is presented using autologous rib grafts without division of the intact inferior sternum. This technique provides protection of the anterior and superior mediastinum without the use of foreign material, destabilization of the sternum, or compromise of respiratory mechanics.