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Published on: March 28, 2025
An alternative surgical approach to subclavian and innominate stenosis: a case series
Amina Khalil1, Samer A M Nashef
1Department of Cardiothoracic Surgery, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK. aminakhalil06@hotmail.com
Insights
Surgical bypass grafting effectively treated symptomatic stenosis of great vessels and supra-aortic trunks. Procedures ensured good graft flow and symptomatic relief, demonstrating a successful treatment for these vascular conditions.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Thoracic Surgery
Background:
- Stenosis of the great vessels and supra-aortic trunks can cause significant symptoms.
- Surgical intervention is a potential treatment option for severe cases.
Observation:
- Three patients with symptomatic stenosis of great vessels or supra-aortic trunks were identified.
- Two patients underwent bypass via manubriotomy, and one via median sternotomy due to concurrent coronary revascularization.
Findings:
- All three patients experienced complete symptomatic relief following surgical bypass.
- Radiological imaging confirmed excellent graft patency and flow in the post-stenotic arteries.
Implications:
- Aorto-subclavian and aorto-innominate bypass grafting are effective surgical solutions for supra-aortic trunk stenosis.
- These bypass techniques offer durable symptomatic relief and maintain arterial patency.
Abstract:
We report three cases of symptomatic stenosis of the great vessels or supra-aortic trunks successfully treated surgically with aorto-subclavian and aorto-innominate bypass. Two were performed via manubriotomy and a third case via standard median sternotomy because of concomitant coronary revascularisation. There was complete symptomatic relief on follow-up, and radiological imaging confirmed good flow in the grafts and post-stenotic arteries.