RCT to Evaluate STERN FIX Device as a Sternal Stabilization System in Patients After Sternotomy (FIXTER-2)

Inclusion Criteria: Patient undergoing surgery that requires median sternotomy Patients with at least one of the following risk criteria: obesity (BMI>30), diabetes, COPD, non serious osteoporosis (not associated with fractures), creatinine > 200 µmol/L and/or under dialysis treatment, scheduled Bilateral Internal Mammary Artery (BIMA) grafting Patients willing and capable of granting informed consent to participate in clinical research and who have granted written consent Patient willing and capable of complying with the protocol requirements Exclusion Criteria: Patient with suspected or known allergies or intolerance to the device material (PEEK - polyether-ether-ketone and carbon fibre) Patient with insufficient quality or quantity of bone or any other serious structural bone damage at the sternum Patient with serious osteoporosis (associated with fractures) or a degenerative bone disease affecting the sternum Patients with a latent or active infection or inflammation at the surgical area, that according to the surgeon criteria may interfere in the device implantation or proper function. Patient with sternal anomalies that, according to the surgeon criteria, prevent the use of the product, such as bone tumours in the implantation area. Pregnant patients or patients planning to become pregnant during the first 6 months after surgery. Patients with diagnosis of dementia with a mental status score (MMSE) < 20. Patients with life expectancy lower than 6 months. Patients involved in other interventionist clinical trials or that have been involved in other interventionist clinical trials during the previous 4 weeks Parasternal sternotomy. Patients with intraoperative conditions that, according to the surgeon's opinion, require or exclude the use of a specific sternal closure system, or that cannot be closed following the study products instructions for use. IMPORTANT: When the allocated closure method is wires only, the surgeon must assess whether the patient could have also had STERN FIX implanted in order to decide if the patient can continue in the study.