Is Left Innominate Vein Ligation during Aortic Arch Surgery Always Safe? A Case Report

Nikolaos Schizas; Vasilios Patris; Ilias Samiotis; Eleni Nikoli; Niki Lama; Michail Argiriou

doi:10.18502/jthc.v17i1.9322

Nikolaos Schizas Department of Cardio Thoracic and Vascular Surgery, Evangelismos General Hospital of Athens, Athens, Greece.
Vasilios Patris Department of Cardio Thoracic and Vascular Surgery, Evangelismos General Hospital of Athens, Athens, Greece.
Ilias Samiotis Department of Cardio Thoracic and Vascular Surgery, Evangelismos General Hospital of Athens, Athens, Greece.
Eleni Nikoli Department of Anesthesiology, Evangelismos General Hospital of Athens, Athens, Greece.
Niki Lama Research Unit of Radiology and Medical Imaging, Kapodistrian University of Athens, Athens, Greece.
Michail Argiriou Department of Cardio Thoracic and Vascular Surgery, Evangelismos General Hospital of Athens, Athens, Greece.

DOI: https://doi.org/10.18502/jthc.v17i1.9322

Keywords: Brachiocephalic veins; Brain edema; Aortic aneurysm; Ascending aorta; Aorta, thoracic

Abstract

Ligation of the left innominate vein (LIV) expands the surgeon’s surgical field for ascending aorta and aortic arch procedures. Although it is considered a safe technique by most surgeons in that it is associated with only minor drawbacks, conflicting views exist regarding this method. We herein describe a 70-year-old woman who underwent ascending aorta replacement due to an aneurysm with subsequent cerebral dysfunction caused by extended brain edema, possibly related to LIV ligation, leading to her death.