Traumatic Fistula Between The Brachiocephalic Trunk And The Brachiocephalic Vein Due To Gunshot Wound [fístula Traumática Entre Tronco Braquiocefálico E Veia Braquiocefálica Por Arma De Fogo]

We describe the case of a 49-year old male patient who suffered a gunshot wound in the chest which transfixed the medial mediastinum. He was hemodynamically stable, but had tachycardia and tachypnea. He was submitted to integrated work-up with chest radiogram, transthoracic echocardiography, computerized chest tomography, and arteriography of the aortic arch. A traumatic fistula was evidenced between the brachiocephalic trunk and the brachiocephalic vein. Surgical repair was performed using extracorporeal circulation and deep hypothermia with total circulatory arrest. The patient progressed well and was discharged on the fifth day postoperatively.904e20e22+e21+e23Demetriades, D., Theodorou, D., Murray, J., Corrwell, E., Asensio, J., Mortality and prognostic factors in penetrating injuries of the aorta (1996) J Trauma, 40, pp. 761-763Roye, G.D., Zorn, G.L., McGiffin, D.C., Kirklin, J.W., Hamrick, K.M., Bessey, P.Q., Acute repair of aorta-innominate vein fistulas (1995) J Trauma, 39, pp. 753-756Demetriades, D., Penetrating injuries to the thoracic great vessels (1997) J Card Surg, 12 (SUPPL.), pp. 173-180Beall, A.C., Roof, W.R., De Bakey, M.E., Successful surgical management of through-through stab wounds of aortic arch (1962) Ann Surg, 156, pp. 823-826Bickell, W.H., Wall Jr, M.J., Pepe, P.E., Martin, R.R., Genger, V.F., Allen, M.K., Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries (1994) N Engl J Med, 331, pp. 1105-1109Fang, T.D., Peterson, D.A., Kirilcuk, N.N., Dicker, R.A., Spain, D.A., Brundage, S.I., Endovascular management of a gunshot wound to the thoracic aorta (2006) J Trauma, 60, pp. 204-208Demers, P., Miller, D.C., Mitchell, R.S., Kee, S.T., Chagonjian, L., Dake, M.D., Stent-graft repair of penetrating atherosclerotic ulcers in the descending thoracic aorta: Mid term results (2004) Ann Thorac Surg, 77, pp. 81-8