We present a case of difficult esophageal reconstruction after total esopha
gectomy for iatrogenic perforation in a diseased esophagus. The stomach was
used for esophageal reconstruction as a retrosternal microvascularly augme
nted flap; the vascular supply to the stomach had been interrupted during p
revious abdominal operations. The blood supply to the stomach conduit was r
estored by separate arterial and venous anastomosis between the right inter
nal thoracic vessels and the left gastric vessels. (C) 2000 by The Society
of Thoracic Surgeons.