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Ann Thorac Surg 2000;69:1576-1578
© 2000 The Society of Thoracic Surgeons

Case reports

Upper limb ischemia after subclavian flap aortoplasty: unusual long-term complication

Frank F. Diemont, MDa, Eric S. Chemla, MDa, Pierre L. Julia, MD, PhDa, Didier Sirieix, MDa, Jean-Noël Fabiani, MDa

a Department of Cardiovascular Surgery, Hôpital Broussais, Paris, France

Address reprint requests to Dr Fabiani, Département de Chirurgie Cardio-Vasculaire, Hôpital Broussais, 96, rue Didot, 75674 Paris Cedex 14, France

Repair of isolated coarctation of the aorta by subclavian flap aortoplasty carries the disadvantage of impaired blood supply to the left arm. However, ligation of branches of the subclavian artery can be tolerated without manifest ischemia of the upper extremity. We report the case of a young man who suffered from left upper extremity ischemia 18 years after initial operation. Treatment consisted of carotid-subclavian bypass with good outcome. The surgical approach of coarctation by subclavian aortoplasty should be reserved for specific cases, and if this procedure is performed, ligation of branches of the subclavian artery should be minimized to increase inflow into the left brachial artery.




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