[Disinsertion of the left innominate vein during median vertical sternotomy (author's transl)]

The left innominate vein may be torn during median vertical sternotomy. This tear may in fact be a disinsertion of the venous trunk from the superior vena cava. Repair of this disinsertion is difficult, with a risk of stenosis. It requires the most careful technique, after dissection of the superior vena cava on either side of the tear. It is made much more simple by the use of extracorporeal circulation, which empties and collapses the superior vena cava. Finally, it may be necessary to repair this loss of substance by enlarging it with a fragment of saphenous vein.