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Congress: ECR24
Poster Number: C-13820
Type: EPOS Radiologist (educational)
DOI: 10.26044/ecr2024/C-13820
Authorblock: O. Obaro-Best1, M. Baig1, D. Edelman1, K. Kim1, R. Cosgro1, P-Y. J. Sonke1, S. Maddineni1, J. Meshekow2, P. Gerard1; 1Valhalla, NY/US, 2Philadelphia, PA/US
Disclosures:
Oghale Obaro-Best: Nothing to disclose
Mirza Baig: Nothing to disclose
Daniel Edelman: Nothing to disclose
Kristin Kim: Nothing to disclose
Ryan Cosgro: Nothing to disclose
Pierre-Yves Jacques Sonke: Nothing to disclose
Shekher Maddineni: Nothing to disclose
Jared Meshekow: Nothing to disclose
Perry Gerard: Nothing to disclose
Keywords: Cardiac, Mediastinum, Conventional radiography, CT, Complications, Instrumentation, Dissection, Infection, Trauma
Learning objectives We discuss several procedures for sternotomy and evaluate the various complications.We evaluate the different imaging modalities that may be used in the diagnosis of sternotomy complications.
Read more Background Median sternotomy is one of the most common procedures for various surgical cardiothoracic procedures. The surgical procedure involves splitting the sternum to gain access to the heart and lungs [1].  Other indications for sternotomies include esophagectomy, congenital heart disease, and retrosternal goiter access. Previous studies have shown that sternotomies reduce both short and long term morbidity [2]. Complications of sternotomies are infrequent, but can include, early postoperative infections, technically related and long term complications. A useful method of considering post-sternotomy...
Read more Findings and procedure details On plain film, post-surgical median sternotomy complications include fractured sternal wires, loosening and migration of screws, hematoma and post-operative infection. Broken sternal sutures may migrate from the sternotomy site into other areas such as the pericardium and heart and be associated with pain and sternal dehiscence. Computed tomography scans are beneficial in diagnosing deep sternal wound infections [5]. On CT, evidence of sternal osseous non-union, and sternal infections/abscess can be identified. Findings may be incidental on plain film or present as...
Read more Conclusion Meticulous analysis of post sternotomy sites on imaging studies can shine light on unpredictable postoperative complications and ultimately improve patient care. Post sternotomy issues may be initially detected by the radiologist on the plain radiograph and subsequent imaging exams may follow. Patients who undergo median sternotomy should be closely monitored for signs of complications, and any concerning symptoms should be promptly addressed by their healthcare team.
Read more References Young A, Goga U, Aktuerk D, Aziz Z, Cross S, Balan A. A radiologist's guide to median sternotomy. Clin Radiol. 2024;79(1):33-40. doi:10.1016/j.crad.2023.10.023 Reser D, Caliskan E, Tolboom H, Guidotti A, Maisano F. Median sternotomy. Multimed Man Cardiothorac Surg. 2015 Jul 17;2015:mmv017. doi: 10.1093/mmcts/mmv017. PMID: 26188337. Hota P, Dass C, Erkmen C, Donuru A, Kumaran M. Poststernotomy Complications: A Multimodal Review of Normal and Abnormal Postoperative Imaging Findings. AJR Am J Roentgenol. 2018 Dec;211(6):1194-1205. doi: 10.2214/AJR.18.19782. Epub 2018 Oct 9. PMID: 30300004. Shafi AMA,...
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