Persistent chest wall pain after median sternotomy due to sternal wires. Who is suffering and how effective is wire removal?

Objective: An underestimated complication following heart surgery, through median sternotomy, is a persistent anterior thoracic pain due to sternal wire. We report our experience with complete sternal wire removal, aiming to find a patient profile and evaluate the procedure and its influence on relieving this pain.

Methods: Between April 1995 and July 2007 148 patients were operated because of sternal wire related thoracic pain. Patients' data were retrospectively studied. The patients were interviewed about the outcome of the wire removal.

Results: Patients were average 65.5 years old and mainly pensioner (66.2%) and male (77.8%). Mean operation time was 27.9 minutes. Wire removal was performed 16 months (4–84 months) after the primary procedure. The most of the patients (90.5%) received CABG and only 12 patients (8.1%) did not have an IMA graft. One case of a sternal wound infection occured. By all other patients wound healing was uneventful. The majority of the patients (87.2%) reported relief of symptoms, while 12.8% reported no change or worsening of the pain after wire removal.

Conclusions: Surgical removal of sternal wire sutures is a very simple safe and rapid procedure. The typical patient suffering from this pain is male, pensioner, who hat about 1.5 year before a CABG operation with the use of the left IMA graft. Removal of all wires relieved pain by the majority of patients, although the causes of this pain still remain unknown.