Surgery for subclavian arteriovenous fistula with ruptured pseudoaneurysm using total circulatory arrest

Subclavian arteriovenous (AV) fistula is an uncommon disease and rarely occurs secondary to injury. We herein report a case of a ruptured pseudoaneurysm with a subclavian AV fistula caused by clavicle fixation. In cases of a large ruptured pseudoaneurysm with a massive surrounding hematoma, bleeding control and vessel repair is very difficult. For treatment of this case, we decided that median sternotomy and cardiopulmonary bypass with total circulatory arrest would be a good alternative to surgery.