Arteriovenous Fistulas After Median Sternotomy - Report of 2 cases and review of the literature

Abstract

We report 2 cases of arteriovenous fistulas as a very rare complication following median sternotomy. In the first case a fistula was observed between the right internal mammary artery and vein caused by a sternal wire. The second patient developed a fistula between the innominate artery and left innominate vein after suture repair of a slight hemorrhage from the innominate vein. The latter localization has not been previously described. In both cases the fistulas were discovered by a continuous murmur appearing 12 and 11 days postoperatively. The therapy consisted of resternotomy and resection of the fistulas. The literature is reviewed and etiology, diagnosis and therapy are discussed.