Iatrogenic Left Subclavian Artery-to-Left Brachiocephalic Vein Fistula: Successful Repair without a Sternotomy

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Subclavian vein catheterization can result in arteriovenous fistula formation—a rare complication that will eventually lead to heart failure if left untreated. The world medical literature describes several subclavian artery-to-subclavian vein fistulas and 2 subclavian artery-to-brachiocephalic vein fistulas, both on the right side. To our knowledge, there have been no reports of an iatrogenic left subclavian artery-to-left brachiocephalic vein fistula. We report a case in which this complication occurred after unsuccessful transvenous pacemaker placement. We treated the fistula with a simple surgical technique that avoided the need for a sternotomy. Although stenting is typically the procedure of choice for such fistulas, our technique is useful when stenting is not indicated.

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