ACUTE REPAIR OF AORTA-INNOMINATE VEIN FISTULAS

Penetrating wounds of the central vasculature are highly lethal. Ten c ases of aorta-left innominate vein fistulas have been reported in the past, but most have presented late after injury. We report three succe ssfully managed cases that had a short interval between injury and rep air, and where we used cardiopulmonary bypass with total circulatory a rrest, Preoperative arteriography facilitated planning the operative a pproach. The ready availability of complete radiologic and surgical re sources at a trauma center were responsible for the successful outcome of these highly lethal central vascular injuries.