Thiel R, Bircks W
Department of Thoracic and Cardiovascular Surgery, Heinrich-Heine-University of Düsseldorf, FRG.
Thorac Cardiovasc Surg. 1990 Jun;38(3):195-7. doi: 10.1055/s-2007-1014018.
We report 2 cases of arteriovenous fistulas as a very rare complication following median sternotomy. In the first case a fistula was observed between the right internal mammary artery and vein caused by a sternal wire. The second patient developed a fistula between the innominate artery and left innominate vein after suture repair of a slight hemorrhage from the innominate vein. The latter localization has not been previously described. In both cases the fistulas were discovered by a continuous murmur appearing 12 and 11 days postoperatively. The therapy consisted of resternotomy and resection of the fistulas. The literature is reviewed and etiology, diagnosis and therapy are discussed.
我们报告2例作为正中胸骨切开术后极为罕见并发症的动静脉瘘。第一例中,由胸骨钢丝导致右乳内动脉与静脉之间出现瘘管。第二例患者在无名静脉轻微出血的缝合修复术后,无名动脉与左无名静脉之间形成了瘘管。后一种部位此前未见报道。两例均在术后12天和11天通过持续杂音发现瘘管。治疗包括再次胸骨切开术及瘘管切除术。本文回顾了相关文献并讨论了病因、诊断及治疗。