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Published on: March 27, 2018
Not all sternotomies indicate previous coronary artery bypass grafting surgery
Rebekah Mulligan1, Muhamad Usman Khan, Rami N Khouzam
1At the University of Tennessee Health Science Center in Memphis, Tenn., Rebekah Mulligan is a resident and Muhamad Usman Khan is a cardiology fellow. Rami N. Khouzam is an associate professor at the University of Tennessee Health Science Center and program director of the interventional cardiology fellowship program. He also is director of the cardiac catheterization laboratory at Methodist University Hospital and division chair of cardiology and medical director of the echocardiography laboratory and non-invasive/treadmill and nuclear stress test laboratory at Methodist South Hospital in Memphis, Tenn. The authors have disclosed no potential conflicts of interest, financial or otherwise.
Insights
Sternal wires on imaging do not always indicate prior coronary artery bypass grafting (CABG). Misinterpreting these wires can lead to incorrect diagnoses and unnecessary healthcare costs for patients.
Area of Science:
- Cardiovascular Surgery
- Radiology
- Medical Diagnostics
Background:
- Coronary artery bypass grafting (CABG) is a frequent surgical procedure.
- Radiographic evidence like sternal scars or wires is often presumed to indicate prior CABG.
- However, sternal wires can result from various cardiothoracic surgeries, not exclusively CABG.
Observation:
- Two patient cases are presented where sternal wires were misinterpreted.
- The patients had not undergone prior CABG surgery.
- The sternal wires were from other cardiothoracic procedures.
Findings:
- The presence of sternal wires on radiographic images is not definitive proof of prior CABG.
- Sternal wires can result from various cardiothoracic surgeries.
- Misinterpretation can lead to diagnostic errors.
Implications:
- Accurate identification of prior cardiac procedures is crucial for patient management.
- Misdiagnosis can lead to unnecessary treatments and increased healthcare expenditure.
- Radiologists and clinicians should consider differential diagnoses when observing sternal wires.
Abstract:
Coronary artery bypass grafting (CABG) is one of the most commonly performed surgeries. Clinicians often assume that a sternal scar or sternal wires seen on radiographic images are evidence of previous CABG. However, these wires could be related to other cardiothoracic surgeries. Incorrectly assuming that patients have coronary artery disease can affect their future management and increase healthcare costs. This article discusses two patients who were misidentified as having previous CABG based on the presence of sternal wires on chest radiographs.
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