Ask Dr. Z

Patient has right internal jugular vein occlusion and innominate vein occlusion with massive symptomatology head edema, saphenouse vein was harvested, median sternotomy was performed and innominate vein to right atrium bypass was performed with spiral vein conduit. Right atrial appendage was free of any lesion and was a good location for distal bypass, innominate vein was dissected, and found to be hard and filled with throbus. Innominate vein was transected , stump leading to superior vena cava was over sewn with 2 layer suture. innominate vein leading to the axillary and subclavian and jugular was explored, thrombus was evacuated. Next using the consturcted spiral vein conduit with a running polene suture, end to end anastomosis of the vein to the innominate stump was performed. Would you stil use 34502? Thanks for your help Dr. D