This case report describes the use of allograft fibula to stabilize the sternum and prevent myocardial compression after an orthotopic cardiac transplantation with a size discrepancy. This technique was well tolerated and maintained the stability of the sternum, as demonstrated on serial chest radiograms and computerized tomography. Normal cardiac function was observed after the procedure, without signs of local infection or graft failure. Complications related to prolonged ventilatory support, pneumonia, and renal failure contributed to the patient's demise 167 days after the transplant.
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