Using Microvascular Anastomotic Coupler System for Venous Anastomosis of Internal Mammary Vein in Breast Reconstruction

Abstract

Microsurgery replacing like tissue with like tissue from a distant site has revolutionized the strategy of reconstruction. The microvascular venous anastomosis remains one of the most challenges for breast reconstruction using internal mammary vessels as the recipient site. The objective of this study was to study the outcome of using Microvascular Anastomotic Coupler (MAC) System for venous anastomosis of internal mammary vein (IMV) in breast reconstruction. Between March of 2003 and December of 2005 seven deep inferior epigastric perforator (DIEP) flaps with the IMV as the recipient sites were used for breast reconstruction. Five flaps (71.4%) were in delayed reconstructions and two flaps (28.6%) in immediate recosntructions. Six reconstructions were for the treatment of post mastectomy breast defect and one was for resurfacing of post- burn scar contracture. The venous anastomoses were performed using the MAC in the 7 reconstructions. All the venous anastomoses were patent, giving a 100% success rate. None of the patients manifested any peri-operative complication or long-term foreign body reaction. The MAC has the advantages of relative easy use, time saving and less technique demand. The MAC is a reliable technique with high patency rate and low complication rate. It is advised to use in venous anastomosis of internal mammary vein for breast reconstruction.