Use of an extra-anatomical bypass to the axillary artery to revascularize the subclavian artery during complex aortic surgeries: an alternate option in difficult cases.

Revascularization of the subclavian artery during complex arch surgeries may be challenging. Options include ligation of the subclavian artery with or without in situ revascularization. In cases of complex reoperations of the arch, or in the presence of large arch aneurysms with a leftward displacement of the subclavian artery, in situ revascularization may be difficult or impossible. Furthermore, an aberrant subclavian artery also obviates in situ revascularization through a sternal approach. We herein report our experience with the use of an extra-anatomical bypass to revascularize the subclavian artery in these circumstances.