Eur J Cardiothorac Surg 2005;28:328-329
© 2005 Elsevier Science NL
Images in cardio-thoracic surgery |
Brachiocephalic artery to left innominate vein fistula following median sternotomy
Rajnish Duara
a
,
*
,
Puthuvassery Raman Suneel
b
,
Thomas Koshy
b
,
Kurur Sankaran Neelakandhan
a
a Department of Cardiovascular and Thoracic Surgery, Sree Chitra Thirunal Institute for Medical sciences and Technology, Thiruvananthapuram, Kerala 695011, India
b Department of Anaesthesiology, Sree Chitra Thirunal Institute for Medical sciences and Technology, Thiruvananthapuram, Kerala 695011, India
Received 17 March 2005;
received in revised form 2 May 2005;
accepted 3 May 2005.
* Corresponding author. Tel.: +91 471 2524551/2524561. (Email: rajnishduara{at}rediffmail.com; rajd{at}sctimst.ker.nic.in).
Key Words: Brachiocephalic artery • Innominate vein • Fistula • Sternotomy
Nineteen-year-old girl operated for ostium secundum ASD sustained injury to the left innominate vein during sternotomy, and was repaired immediately. Pulse Doppler (Fig. 1
) revealed continuous flow across the fistula and DSA (Fig. 2
) showed flow to the left innominate vein into the superior vena cava. Fistula successfully repaired on 10th postoperative day.
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Fig. 1. Pulse Doppler showing communication between brachiocephalic artery and left innominate vein with continuous flow across the fistulous tract.
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Fig. 2. Digital Subtraction Angiogram showing injection to the brachiocephalic artery and instant filling of the left innominate vein and subsequently superior vena cava.
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