CTICasesSternotomy Wire Perforation of the Right Ventricle
Imaging findings
Lateral chest radiograph shows abnormal retrosternal looping of a sternotomy wire. Sagittal CT reconstruction confirms that the wire loops abnormally deep posteriorly, penetrating through the sternum directly into the right ventricular myocardium.
Key takeaways
Sternotomy wires are commonly used to close the sternum post-cardiac surgery. Sternal instability, fractured wires, or poor closure technique can result in posterior migration or deep looping of the wire, leading to myocardial perforation (typically of the right ventricle). Careful evaluation of wire courses on lateral radiographs or CT is critical in symptomatic post-operative patients.
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