Pins and wires offer the simplest and most effective tools for managing bone fractures and dislocations. Migration of these devices within the chest is rare, but can cause serious problems. The spontaneous migration of Kirschner wires from the right clavicle to the mediastinum resulted in penetrating injury of the esophagus and pseudo-aneurysm of the brachiocephalic artery in an 84-year-old pat...

The combination of right aortic arch with aberrant left brachiocephalic artery and aortic coarctation is very rare. Here, we report the case of a 3.1-kg neonate with multiple malformations who received detailed preoperative anatomical definition by chest computed tomography (CT) scan and eventually underwent one-stage repair at the age of 17 days. The surgical technique included left brachiocep...

The variations in the aortic arch and its branches are of surgical interest. Many anomalies of the aortic arch and great vessels are uncovered as serendipitous findings on imaging studies, in the anatomy laboratory, or at surgery. A 56-year-old woman had an arch angiogram as part of an evaluation for cardiovascular disease. A two-vessel left aortic arch was identified consisting of the brachioc...

Superior mediastinum contains many important vessels and tubes, variation of one may affect the other. Left brachiocephalic vein crosses arch of the aorta and its branches superficially. Arch of the aorta from its convex superior aspect usually provides brachiocephalic, left common carotid and left subclavian artery from the right to left. Left subclavian artery continues as axillary artery and...

Figure 1: CT images. (A) Preoperative three-dimensional CT image. Dextrocardia was observed preoperatively. The branches of the aortic arch were mirror-image reversed. (B) Postoperative three-dimensional CT image. Reconstructed aorta and branches were also mirror-image reversed. RV: right ventricle; Ao: aorta; BCA: brachiocephalic artery; Rt.SCA: right subclavian artery; Rt.CCA: right common ca...

The lymphatics lying along the internal thoracic artery and vein, which are termed the "internal mammary lymphatics" (IML), were minutely dissected in 134 adult cadavers (80 males and 54 females, aged 27-94 years) in order to clarify the configuration of IML in the superior mediastinum. On the right side, IML frequently terminated at the brachiocephalic angle (BA) nodes and often at the nodes s...

In nine dogs under pentobarbital anesthesia, electromagnetic flow transducers were implanted around the ascending aorta, brachiocephalic artery, superior mesenteric artery, and iliac artery. A catheter to measure arterial pressure was implanted into the thoracic aorta. After full recovery, hemodynamic variables were measured daily in conscious dogs in five sets of recordings: control, during an...