title: Distal arteriovenous fistula to maintain patency of the venous drainage of a latissimus dorsi flap following subclavian vein repair.
abstract: Successful reconstructive surgery with muscle flaps depends on adequate arterial supply and undisturbed venous drainage. Combining such surgery with reconstructive vascular surgery of a large-caliber vein that is responsible for the venous drainage of the flap poses an additional challenge--the repaired vein's susceptibility to thrombosis. Every attempt must be made to prevent venous outflow obstruction following muscle flap surgery. Data from the vascular surgery literature demonstrate a low success rate for subclavian vein repair. The success rate with venous reconstructive surgery has been greater when a distal arteriovenous fistula accompanied the repair. The present case described the use of a temporary distal cephalic-brachial arteriovenous fistula to maintain the patency of the venous drainage of a pedicled latissimus dorsi muscle flap, following subclavian vein repair, for one-stage coverage of a large chest wall defect.
authors.affiliation: Plastic Surgery Unit, Carmel Medical Center, Haifa, Israel. yaron07@yahoo.com
authors.forename: Y
authors.initials: Y
authors.lastname: Har-Shai
authors.forename: R
authors.initials: R
authors.lastname: Karmeli
authors.forename: M
authors.initials: M
authors.lastname: Saute
authors.forename: S
authors.initials: S
authors.lastname: Mayblum
authors.forename: A
authors.initials: A
authors.lastname: Taran
authors.forename: A
authors.initials: A
authors.lastname: Barak
authors.forename: Z
authors.initials: Z
authors.lastname: Loberman
authors.forename: U
authors.initials: U
authors.lastname: Naveh
authors.forename: A
authors.initials: A
authors.lastname: Eyal
authors.forename: A
authors.initials: A
authors.lastname: Schramek
mesh_terms: D006607:Adenoma, Sweat Gland / Q000098:blood supply / Q000601:surgery*; D001166:Arteriovenous Shunt, Surgical; D001367:Axillary Vein / Q000601:surgery; D001916:Brachial Artery / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000098:blood supply / Q000601:surgery*; D013350:Subclavian Vein / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D013899:Thoracic Neoplasms / Q000098:blood supply / Q000601:surgery*; D014654:Vascular Patency / Q000502:physiology*