What is the most likely diagnosis?
- 68 year-old 3 weeks post-aortic valve replacement
CT scout image
- Pericardial effusion
- Congestive heart failure
- Sternal dehiscence
- Left lower lobe atelectasis
- Metastatic disease to the lungs
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Answer:
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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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