Poststernotomy Imaging: Pictorial Review of Expected Postsurgical Findings and Complications

Sternotomy is a widely used incision technique in cardiac and thoracic surgeries. Multiple sternotomy techniques exist, such as the Robicsek technique for redo sternotomy and transverse (clamshell) thoracosternotomy for bilateral lung transplantation. Various complications after sternotomy can occur, and imaging plays a key role in their identification. Complications may involve the hardware, sternum, and peristernal soft tissues and are divided into acute, subacute, and late. Acute complications primarily involve hemorrhage and dehiscence, while subacute complications include superficial or deep sternal wound infections and late complications are typically osseous or hardware related. Imaging also plays a critical role in assessment of cardiovascular structures and their relations to the sternum in those undergoing redo sternotomy, which has become increasingly performed. CT allows radiologists to identify the relationship of vascular anatomy to the sternum as well as other factors that may complicate repeat surgery, allowing surgeons to strategize safe surgical approaches.