Intravascular Ventricular Assist Device
Currently the brand name is NuPulse iVAS. This is essentially a long-term implanted intra-aortic balloon pump. It includes several subcutaneous ECG leads in the chest wall; an axillary radiopaque implanted sheath; and a single radiopaque marker for the top of the balloon.
Laparotomy Sponge
Surgical sponges have a radiopaque band to help identify them. They may be placed for packing an open wound or retained inadvertently after surgery. The sponge marker is often broad, whereas gauze has small crinkled lines.
This patient has an open sternotomy and biventricular assist devices.
Median Sternotomy Wires
Wires used to close the surgical sternotomy, typically after cardiac or mediastinal surgery. Wires may tied in several fashions, e.g. cerclage, figure-of-eight. Very small wires are indicative of prior pediatric surgery, i.e. congenital heart disease.
Wires may fracture if the sternotomy is nonunited and there is motion. This is typically of no significance. However, in the immediate post-surgical setting wire fracture or wire migration can indicate sternal dehiscence.
Spinal Fusion
Generally involves rods (as seen here) as well as either pedicular screws or laminar hooks (the latter seen here) to provide initial fixation. Bone graft material, often difficult to see, provides long-term fusion of the involved levels.
Surgical Gauze
Surgical gauze is used for packing and contains radiopaque markers to help identify it on radiographs. It may be left in an open wound or retained inadvertently.
This patient with an open sternotomy has multiple gauzes and a single sponge in the lower chest.