CTICasesRetrosternal Reconstruction with Rectus Abdominis Muscle Flap
Imaging findings
CT chest in a heart transplant recipient shows a rotated muscle flap (rectus abdominis muscle) transposed subxiphoid into the prevascular mediastinum to fill a retrosternal defect. There is absence of sternal wires and evidence of healed sternal osteomyelitis.
Key takeaways
Sternal osteomyelitis and retrosternal abscess are serious complications of median sternotomy. Treatment involves debridement and reconstruction using vascularized tissue flaps (e.g., rectus abdominis or omentum) transposed into the mediastinum, which fills the dead space and provides a rich blood supply to clear infection.
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