Arteriovenous loops and plastic reconstructive surgery for coverage of deep sternal defects after cardiac surgery

Sternal defects after sternotomy and cardiac surgery are a serious problem. In many cases healing is insufficient due to a comprimized blood supply, The presentation will demonstrate an effective concept. At first, vascular suppy is provided by an arteriovenous loop, in most cases between the subclavian artery and the subclavian vein by an autologous conduit (greater saphenous vein in reversed technique). After an interval of several day a two-timed free flap will cover the defect. Vascular anastomoses are performed between the flap vessels and the loop. The loop will be divided at the apex. Thus, an "artery" and a "vein" for the free flap are provided.
The presentation will give an overview of the indications, surgical techniques and outcomes of the procedure.