Bilateral free flap breast reconstruction using venous cross-over bypass to contralateral internal mammary artery for salvaging thrombosed arterial anastomosis in unilateral repeated irradiation of the breast: A case report.
Journal
Microsurgery
ISSN: 1098-2752
Titre abrégé: Microsurgery
Pays: United States
ID NLM: 8309230
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
revised:
28
08
2021
received:
19
04
2021
accepted:
28
10
2021
pubmed:
17
11
2021
medline:
20
4
2022
entrez:
16
11
2021
Statut:
ppublish
Résumé
Adjuvant radiotherapy in breast cancer patients might enhance complications after autologous breast reconstruction, including thrombosis of the internal mammary artery (IMA) precluding its use as recipient vessel. This case report shows a salvage procedure for thrombosis of the IMA during bilateral autologous breast reconstruction in a 51-year-old patient who had undergone repeated irradiation of the chest wall after Hodgkin's disease and recurrent breast carcinoma of the right side. After mastectomy of the right breast and prophylactic mastectomy of the left breast, the patient desired breast reconstruction with autologous tissue. During simultaneous bilateral breast reconstruction using two deep inferior epigastric perforator (DIEP) flaps anastomosed to the left and right inframammary vessels, arterial anastomosis to the right IMA was not feasible due to arterial thrombosis. A salvage procedure using an interpositional cephalic vein graft as a crossover bypass and a subcutaneous presternal tunnel was used. The inferior epigastric artery of the right DIEP flap was anastomosed to the venous bypass, which was anastomosed to the contralateral IMA. Both flaps healed without any complications during the postoperative course and follow up of 6 months. The presented case shows the feasibility of a cross-over venous bypass procedure during bilateral breast reconstruction as salvage maneuver for the arterial anastomosis after repeated radiation of the unilateral breast.
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
372-375Informations de copyright
© 2021 The Authors. Microsurgery published by Wiley Periodicals LLC.
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