We would like to thank the authors for their interest in our article named "Repair of a complete sternal cleft in a five-month-old female infant."[1] We also thank the authors for their reported adult case in the literature about the same medical topic.[2] They successfully performed direct repair in a 35-year-old female with a defect width of 6 cm.

The authors stated that the huge amount of foreign material with the potential for untoward reactions, infection, extra weight on the sternum, and the difficulty of going back for cardiac or mediastinal surgical procedures in the future are the main drawbacks and hazards of secondary reconstruction. We believe that their opinions are correct. However, as reported in the literature, if primary closure is not possible due to a wide sternal gap, secondary maneuvers, including autologous grafting or reconstruction materials, should be considered.[3,4] Furthermore, the usage of metallic plates is favored in patients with an insufficient sternal bone.[5] Our patient had an isolated complete sternal with a defect size of about 6 cm (too wide for an infant), and thus, we preferred secondary reconstruction in our case. The patient was carefully monitored during the surgery, which demonstrated no cardiac compression signs, and control echocardiography at the first year was normal.

Data Sharing Statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.

Conflict of Interest: The author declared no conflicts of interest with respect to the authorship and/or publication of this article.

Funding: The author received no financial support for the research and/or authorship of this article.

References

1) Özyurtkan MO, Yüksel M, Kutlu N, Demiroluk İŞ, Şimşek B. Repair of a complete sternal cleft in a five-month-old female infant. Turk Gogus Kalp Dama 2024;32:232-235. doi:10.5606/tgkdc.dergisi.2024.23833.

2) Jabbad H, Shehata R, Al-Ebrahim K. Successful surgical repair of complete sternal cleft in an adult. Asian Cardiovasc Thorac Ann 2010;18:376-8. doi: 10.1177/0218492310376015.

3) Hinchcliff KM, Xue Y, Wong GB. Reconstruction of Congenital Sternal Cleft: A Systematic Review of the Literature. Ann Plast Surg 2021;86(5S Suppl 3):S418-S421. doi: 10.1097/SAP.0000000000002724.

4) Torre M, Rapuzzi G, Carlucci M, Pio L, Jasonni V. Phenotypic spectrum and management of sternal cleft: literature review and presentation of a new series. Eur J Cardiothorac Surg 2012;41:4-9. doi: 10.1016/j.ejcts.2011.05.049.

5) Kothari P, Gupta A, Patil PS, Kekre G, Kamble R, Dikshit KV. Complete sternal cleft - A rare congenital malformation and its repair in a 3-month-old boy: A case report. J Indian Assoc Pediatr Surg 2016;21:78-80. doi: 10.4103/0971-9261.176961.