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Robert T. Baldwin
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Ann Thorac Surg 1991;52:1342-1343
© 1991 The Society of Thoracic Surgeons

Articles

Subclavian vein-to-right atrial bypass for symptomatic venous hypertension

J.Michael Duncan, MD*, Robert T. Baldwin, MD, James P. Caralis, DO, Denton A. Cooley, MD

Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Texas USA

Accepted for publication August 6, 1991.

* Address reprint requests to Dr Duncan, Department of Cardiovascular Surgery, Texas Heart Institute, PO Box 20345, Houston, TX 77225-0345 USA.

A new surgical technique for bypassing subclavian vein thromboses in patients undergoing hemodialysis is presented. Subclavian vein stenosis or occlusion can occur after the use of temporary access catheters in subclavian vein dialysis. If this occurs in a patient with an arteriovenous access fistula of an ipsilateral upper extremity, venous hypertension, massive edema of the arm, and dysfunction of the access graft may result. In 2 patients with this condition, we successfully performed axillary vein-to-right atrial bypass, which resolved swelling and restored function of the access graft. This may be an appropriate surgical option for symptomatic venous hypertension in such patients.




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