Post coronary artery bypass chest X ray PA view

Chest X ray PA view after coronary artery bypass showing the sternal wires and clips used for occluding the side branches of the left internal mammary artery. The magnified views are given below for better delineation.

Magnified view of sternal wires on chest X ray after CABG

Sternal wires are used to hold the two sides of the sternum divided during midline sternotomy together for the intial few months during which firm bony union occurs. This reduces sternal instability and chance for sternal wound dehisence. Occasionally one of these wires can get infected and erode outside the skin, necessitating removal at a later date.

Clips occluding branches of left internal mammary artery

Clips are used to occlude the side branches of the left internal mammary artery (LIMA) which is used for grafting the stenotic left anterior descending artery. The branches removed are the anterior intercostal arteries.