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Dr. Andrew Rynne
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Dr. Andrew Rynne

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What are the long term affects of wire fragment migration in chest?

Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 7137 Questions

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Posted on Wed, 24 Aug 2016 in Valvular Heart Disease
Question: What impact can a 15mm fragmented sternotomy wire migrating within the pericardium have long term????? My husband had aortic aneurysm graft repair surgery Feb 2015, 2 bouts of pericardial effusion within the next 2 months, ending with pericardial window. Wire fragment was discovered Aug 2015. He is still experiencing chest pain and a "catching" thud sound when turning in certain positions. What kind of further long term complications might he expect from the wire fragment? Thank you for your time.
doctor
Answered by Dr. Ilir Sharka 38 minutes later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I carefully passed through your question and would explain that this is a common complication of chest surgery.

The complications related to the wire fragment migration, depend on the organ affected by the wire contact:

a- it can cause repeated pericarditis caused by inflammation and irritation of the pericardial layers when the wire gets in contact with it

b- it can get in contact with the coronary arteries and cause acute coronary events by their occlusion

c- it can damage the heart muscles, if it migrates in the myocardial space, leading to cardiomyopathy

d- it can migrate in the blood flow directed to other organs and cause similar symptoms in other organs (including the brain and the lungs).

Coming to this point, I would recommend performing a chest CT scan study to locate the migrating wire fragment and remove it with surgery, in order to avoid the above mentioned possible complications.

Hope you will find this answer helpful!

Feel free to ask any other questions whenever you need!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 5 hours later
According to my husbands most recent Chest X-ray, the wire is now "superimposing the left upper abdomen anteriorly which is most likely located in the pericapsular fat"". Where in previous scans that were tracking it's movement, it had been referred to as a sternotomy wire, suture wire, and surgical wire, it is now being referred to as a broken wire suture. What kind of risk does the location in the pericapsular fat identified by the radiologist on 6-29-2016 cause?? Is there a possibility that it can move again?????
doctor
Answered by Dr. Ilir Sharka 8 hours later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

It can cause celulitis or inflammation in this region, leading to peritonitis too (as these structures are connected with each other).

I recommend discussing with your attending physician the possibility of microsurgery to remove this peace of wire. It is a simple intervention, with a really small excision.

Another option for the removal is endoscopy or laparoscopy. It is simple and non traumatic. It does not need a big incision on the skin.

I would strongly encourage you to discuss with your doctor the possible options for its removal from his body.

Hope you will find this answer helpful!

Best wishes,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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