Left innominate vein stenosis treated with graft replacement with concomitant cardiac surgery

Left innominate vein stenosis is a serious complication that causes massive venous hypertension and vascular access failure in patients requiring hemodialysis. Percutaneous transluminal angioplasty has been the standard treatment strategy; however, the outcome has been unsatisfactory, with a low primary patency rate. We present the case of a 49-year-old man with symptomatic left innominate vein stenosis that was successfully treated with graft replacement concomitantly with aortic valve replacement via median sternotomy. During surgery, appropriate cardiopulmonary bypass circulation should be established to avoid cerebral venous hypertension, which can cause irreversible brain damage.