To Remove or Not to Remove: Conservative Management of a Sternal Wire Migrating into the Right Ventricle after lung transplantation

Sternal wire fragmentation is a common radiographic finding. However, sternal wire displacement is a rare and often serious complication. We report a case of a 68-year-old man who was incidentally found to have sternal wire migration into his right ventricle three years post-lung transplant. Retrieval was attempted via a left parasternal approach but the wires were not visible intraoperatively to facilitate removal. As the patient was asymptomatic with no adverse outcomes and the surgery was considered high risk, a decision was made not to pursue major surgery to remove the wires. Instead, the case was managed conservatively with ongoing surveillance for any further migration of the wires or associated complications.