Successful free flap salvage upon venous congestion in bilateral breast reconstruction using a venous cross-over bypass: A case report

Journal article


Publication Details

Author(s): Steiner D, Horch RE, Ludolph I, Arkudas A
Journal: Microsurgery
Publication year: 2019
ISSN: 0738-1085


Abstract

Abdominal free flaps such as the muscle sparing transverse rectus abdominis myocutaneous (ms-TRAM) or deep inferior epigastric artery perforator (DIEP) flap represent the gold standard in autologous breast reconstruction. We describe a salvage procedure during bilateral free flap breast reconstruction due to insufficient venous drainage using a venous cross-over bypass. A 54-year-old woman with a thrombosis of the left subclavian port-system in the medical history was elected for simultaneous bilateral breast reconstruction with ms-TRAM and DIEP flaps. Intraoperatively, a venous congestion of the DIEP flap, which was connected to the left cranial internal mammary vessels, appeared. In the absence of sufficient ipsilateral venous recipient vessels, we performed a salvage procedure requiring a 15 cm small saphenous vein graft and presternal subcutaneous tunneling. The flap vein was anastomosed end-to-end with the contralateral caudal internal mammary vein using a coupler system. The postoperative course was uneventful and both flaps survived. We describe the cross-over venous emergency bypass as a useful tool in unexpected venous thrombosis during bilateral free flap breast reconstruction.


FAU Authors / FAU Editors

Arkudas, Andreas Prof. Dr.
Medizinische Fakultät
Horch, Raymund E. Prof. Dr.
Professur für Plastische Chirurgie und Handchirurgie
Steiner, Dominik Dr. med.
Plastisch- und Handchirurgische Klinik


How to cite

APA:
Steiner, D., Horch, R.E., Ludolph, I., & Arkudas, A. (2019). Successful free flap salvage upon venous congestion in bilateral breast reconstruction using a venous cross-over bypass: A case report. Microsurgery. https://dx.doi.org/10.1002/micr.30423

MLA:
Steiner, Dominik, et al. "Successful free flap salvage upon venous congestion in bilateral breast reconstruction using a venous cross-over bypass: A case report." Microsurgery (2019).

BibTeX: 

Last updated on 2019-22-05 at 08:38