CTICasesIntrapericardial Sternal Wire Migration
Imaging findings
Serial chest CT scans in a patient with a prior lung transplant show multiple fractured clamshell sternotomy wires. Over a two-month period, a wire fragment is seen migrating progressively into the pericardial space. It eventually wraps around the right atrium, associated with a small pericardial effusion and localized pericardial inflammation.
Key takeaways
Fracture of sternotomy wires is a common finding, but migration of a wire fragment is a rare and potentially catastrophic complication. Wire fragments can migrate into the pleural space, lung parenchyma, pericardium, or directly puncture the heart chambers or great vessels. Prompt surgical removal is indicated if migration is demonstrated.
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