The completed bypass is illustrated. The wound was closed in layers. Graft coverage was provided by returning the fat pad to its anatomic position. The cut edges of the clavicular head of the sternocleidomastoid muscle were then re-approximated. The platysma muscle was closed in running simple fashion, and a subcuticular stitch was used to bring the skin edges together.
The operation was performed without immediate complication. Postoperatively, the patient reported complete resolution of the exercise intolerance in his arm. In addition, on physical examination, he had bounding pulses in his brachial and radial arteries, and his brachial artery blood pressures were equal.
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