# A case of thoracic central venous obstruction treated by the innominate-to-right-atrial bypass grafting technique under extracorporeal circulation

## TL;DR

A 46-year-old woman with kidney disease and a blocked vein was successfully treated with a rare surgical bypass technique under extracorporeal circulation.

## Contribution

The paper presents a rare surgical solution for thoracic central venous obstruction when percutaneous methods fail.

## Key findings

- The innominate-to-right-atrial bypass grafting technique successfully resolved thoracic central venous obstruction.
- This surgical approach is effective when percutaneous procedures are not possible.
- The technique may improve prognosis for patients with central venous obstruction.

## Abstract

A 46-year-old woman with stage 5 chronic kidney disease was unable to undergo hemodialysis treatment due to thoracic central venous obstruction (TCVO) and blockage of the tunneled cuffed catheter. This patient also presented with symptoms of TCVO. When percutaneous procedure was not possible, we resolved the obstruction with the innominate-to-right-atrial bypass grafting technique under extracorporeal circulation. There are few reports on this surgical approach. In terms of patient prognosis, this may be an effective solution to this problem.