Axillary disruption of axillobifemoral graft

Axillary disruption of axillobifemoral grafts has not previously been reported after appropriate placement of the graft medially on the axillary artery and proper subpectoral tunneling. Six weeks after undergoing such surgery followed by a relatively uncomplicated postoperative course, the patient--an 81-year-old man--was found unconscious at home. He was resuscitated, and taken to an emergency room where he had a respiratory arrest. At surgery, it was found that the polytetrafluoroethylene graft had separated from the axillary artery. Inspection of the axillary artery showed a completely intact suture line on the artery itself. Graft cultures tested negative. The authors believe the anastomotic disruption was the result of trauma to the anastomosis during cardiopulmonary resuscitation and external cardiac massage.