Sleeper Wire: A Case of Late Subcutaneous Migration of a Fractured Sternal Closure Cable 12 Years After Coronary Artery Bypass Graft

Sternal wire displacement is a rare but important postoperative complication following median sternotomy, commonly performed during cardiothoracic surgeries, such as coronary artery bypass grafting (CABG). While wire breakage and migration are known, migration into the deep subcutaneous plane without involvement of intravascular or muscular structures is extremely uncommon. We report a 71-year-old male with a history of triple vessel disease status post CABG 12 years prior, presenting with acute dyspnea. Imaging revealed pulmonary edema and an incidental finding of a migrated sternal wire in the deep subcutaneous plane anterior to the pectoralis major. Serial chest X-rays demonstrated gradual disruption and migration of the lowermost sternal wire over several years. The patient remains asymptomatic regarding the wire migration and is being managed conservatively with regular follow-up. This case highlights an unusual presentation of sternal wire migration confined to the subcutaneous plane, emphasizing the importance of long-term radiological surveillance in post-sternotomy patients. Although often asymptomatic, displaced sternal wires may pose significant risks, necessitating individualized management strategies. Conservative monitoring with periodic imaging is a reasonable approach when the patient is asymptomatic and the wire is stable.