Tracheoplasty for Tracheal Collapse after the Tracheoinnominate Fistula Repair

Hanae Sasaki＊	Ryosuke Kowatari＊	Kazuyuki Daitoku＊
Tomonori Kawamura＊	Shiho Yamazaki＊	Masahito Minakawa＊

（Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan）

A 13-year-old boy underwent tracheostomy due to post-cardiac arrest encephalopathy in our hospital. During the second postoperative month, massive bleeding from the tracheostomy tube lumen was observed; tracheoinnominate artery fistula was diagnosed. Two weeks postoperatively, the trachea collapsed; tracheoplasty with VA-ECMO was performed. The patient was placed in respiratory distress and the tracheostomy cannula was removed. The damaged part of the trachea was trimmed to form a fusiform structure, while the horizontal mattress suture technique was used for tracheoplasty. An endotracheal tube was then placed just above the tracheal bifurcation and the tracheoplasty site was rested. On postoperative day 15, the tube was changed to a tracheostomy one; 3 months postoperatively, no tracheostomy-related complications or rebleeding were observed. Therefore, VA-ECMO assisted tracheal repair is considered a useful treatment option for patients with tracheal disruption, where suturing a prosthesis to the tracheostomy stoma site is difficult.

 

Jpn. J. Cardiovasc. Surg. 51: 245-248 （2022）

Keywords：tracheoinnominate artery fistula; innominate artery transection; tracheostomy; tracheoplasty