title: Central venous injuries of the subclavian-jugular and innominate-caval confluences.
abstract: Injuries to the central venous system can result from penetrating trauma or iatrogenic causes. Injuries to major venous confluences can be particularly problematic, because the clavicle and sternum seriously limit exposure of the injury site. We report our institution's experience with central venous injuries of the subclavian-jugular and innominate-caval venous confluences. Significant injuries of the subclavian-jugular venous confluence frequently result from penetrating trauma, while injuries to the innominate-caval confluence are usually catheter-related. Median sternotomy provides adequate exposure of the innominate-caval confluence, while exposure of the subclavian-jugular venous confluence requires extension of the median sternotomy incision into the neck and resection of the clavicle. The literature is reviewed.
authors.affiliation: Harbor-UCLA Medical Center, Torrance, California 90509, USA.
authors.forename: F J
authors.initials: FJ
authors.lastname: Baumgartner
authors.forename: J
authors.initials: J
authors.lastname: Rayhanabad
authors.forename: F S
authors.initials: FS
authors.lastname: Bongard
authors.forename: J C
authors.initials: JC
authors.lastname: Milliken
authors.forename: C
authors.initials: C
authors.lastname: Donayre
authors.forename: S R
authors.initials: SR
authors.lastname: Klein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy / Q000009:adverse effects*; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D002305:Cardiac Tamponade / Q000209:etiology; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013350:Subclavian Vein / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014684:Venae Cavae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014948:Wounds, Gunshot / Q000601:surgery*