Angiographic evaluation of post-sternotomy arteriovenous fistula of the internal mammary artery and vein.

An arteriovenous fistula of the right internal mammary artery and vein following median sternotomy was demonstrated by angiography. This surgical complication has not been previously reported in the literature, despite the recent increase in cardiac surgery via median sternotomy. Clinical and radiologic awareness of this iatrogenic shunt and of its potential delayed appearance and cardiovascular effects are important. Arteriovenous fistulas are usually treated by surgical ligation and excision, or by transcatheter occlusion therapy.