Paradoxical Venous Doppler Signal: A Sentinel Sign of Early Venous Congestion

Eran D. Bar-Meir; Hasan S. Merali; Janet H. Yueh; Adam M. Tobias; Bernard T. Lee

doi:10.1055/s-2008-1078695

Journal of Reconstructive Microsurgery, Table of Contents

J Reconstr Microsurg 2008; 24(4): 255-257
DOI: 10.1055/s-2008-1078695

Paradoxical Venous Doppler Signal: A Sentinel Sign of Early Venous Congestion

Eran D. Bar-Meir¹ , Hasan S. Merali¹ , Janet H. Yueh¹ , Adam M. Tobias¹ , Bernard T. Lee¹

¹Department of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts

Abstract

ABSTRACT

We present a case of early venous congestion in a superior gluteal artery perforator flap for breast reconstruction. The case is unique because the early detection was based on a paradoxical handheld Doppler signal. During reexploration, the vessels were compressed with intermittent obstruction on inspiration. The vessels were repositioned and the flap was salvaged with no further complications. The pathophysiology of this paradoxical sentinel sign is discussed, along with other reasons leading to the outflow obstruction.

KEYWORDS

Microsurgery - reconstructive breast surgery - superior gluteal artery perforator flap - venous congestion

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References

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Bernard T LeeM.D.

Department of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center

110 Francis St. Suite 5A, Boston, MA 02215