Early results of surgical revascularization of the subclavian artery
Gerbitz, J.; Braun, A.; von Segesser, L.K.; Weber, E.; Turina, M.
Helvetica Chirurgica Acta 60(1-2): 171-175
1993
ISSN/ISBN: 0018-0181 PMID: 8226050 Document Number: 412088
In the last 14 years (1978 to 1991) in the Clinic of Cardiovascular Surgery, University Hospital Zurich, 72 patients were operated due to obstruction of the subclavian artery. The left side was affected in 46/72 (63.9%), the right side in 21/72 (29.2%), both sides in 5/72 (6.9%) patients. Only thrombendarterectomy has been done in 48/72 (66.7%), followed by carotis-subclavian-bypass (9/72, 12.5%). Furthermore the following techniques were applied: endarterectomy and patch in 6/72 (8.3%), aorta-subclavian-bypass in 5/72 (6.9%), bypass between proximal and distal subclavian artery in 2/72 (2.8%), resection and graft-interposition in 1/72 (1.4%) cases. As well as operation-related reactions of soft tissues (hematoma, swelling) the following complications have been recognized: re-stenosis with embolus or intima-flap in 8/72 (11.1%) cases, 3-times persistent, paralysis of the vocal cord in 3/72 (4.2%) cases, phrenic nerve paralysis in 2/72 (2.8%), in two separate cases Horner's syndrome and pneumothorax. The oldest patient (81 years) died 10 days after operation due to hemorrhage, in spite of 3 re-thoracotomies. Additional complications arose independently of the subclavian operation (atrial flatter, heart-infarction, lungoedema, exitus following extensive heart-operation with valve-replacement and aorto-coronary bypass).