What's the most likely diagnosis?

• 68 year-old 3 weeks post-aortic valve replacement

CT scout image

1. Pericardial effusion
2. Congestive heart failure
3. Sternal dehiscence
4. Left lower lobe atelectasis
5. Metastatic disease to the lungs

Answer:

 

3. Sternal dehiscence

 

 

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Sternal Dehiscence

General considerations

• Follows median sternotomy usually for cardiothoracic surgery
• Defined as complete separation of the sternum
  • Frequently associated with sternal wound infection, most often by S. aureus
  • May or may not be associated with mediastinitis
    • Definitions for post-sternal mediastinitis and sternal wound infection vary, some including clinical findings only, some requiring microbiological confirmation
• Incidence has been reported in 4.5% of coronary artery bypass graft (CABG) surgeries
• While diagnosis is usually made clinically, imaging plays a key role in either initial diagnosis and/or confirmation of the clinical diagnosis
• Females are at greater risk than males

 

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