@ LIGATION OF THE MAJOR MEDIASTINAL VESSELS, SAFETY AND COMPLICATIONS

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ABBASI DEZFOULI AZIZ ELAH; KESHOOFY M.; JAVAHERZADEH M.; DANESHVAR KAKHAKI A.A.GH.; ARAB M.; SHADMEHR M.; PAZHOUHAN S.

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Journal Paper

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Journal: Iranian Journal of Surgery Year:2004 | Volume:12 | Issue:32 Page(s): 23-28

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Title

@ LIGATION OF THE MAJOR MEDIASTINAL VESSELS, SAFETY AND COMPLICATIONS

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Keywords

MEDIASTINUMQ4

INNOMINATE ARTERYQ4

INNOMINATE VEINQ4

LIGATIONQ4

Abstract

Introduction & Objective: During upper mediastinal, Surgical interventions innominate vessels may be ruptured inadvertently or divided intentionally by the surgeon for a better exposure. "The question, "Whether a divided INNOMINATE ARTERY or vein should be reconstructed or not?" has not yet been clearly answered.Material and Methods: In a retrospective review of hospital records of all patients who underwent any kind of surgery between 1996 and 2004 in our department, 11 patients, 7 females & 4 males were found who had an upper mediastinal surgery with LIGATION of a great vessel.Fourteen great vessels, 6 Innominate arteries - 4 left INNOMINATE VEINs - 3 right INNOMINATE VEINs – one right carotid artery were ligated with no reconstruction.In 6 patients the vessels were intentionally divided & ligated for a better exposure and in 5 for control of severe bleeding due to iatrogenic trauma.Findings: One patient with INNOMINATE ARTERY and right INNOMINATE VEIN division suffered a 48 hours period of coma due to a cerebral edema which recovered completely. Two patients developed sternal wound infections and were managed with antibiotics and wound care. No other complication occurred. In two patients, after division of the Innominate arteries occurred, the peripheral pulses were disappeared but there was no muscle weakness, or ischemic pain of the limb.Conclusions: In critical conditions and when surgical situation is not suitable for reconstruction, INNOMINATE VEINs and artery could be ligated and divided for a better exposure or control of bleeding with acceptable postop risks.

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