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Ann Thorac Surg 1975;20:671-677
© 1975 The Society of Thoracic Surgeons

Articles

Innominate Artery Rupture

A Major Complication of Tracheal Surgery

J. Deslauriers, M.D., R.J. Ginsberg, M.D., J.M. Nelems, M.D., F.G. Pearson, M.D.*

From the Division of Thoracic Surgery, Toronto General Hospital, Toronto Western Hospital, and the University of Toronto, Toronto, Ont., Canada

* Address reprint requests to Dr. Pearson, Division of Thoracic Surgery, University Wing, Room 120, Toronto General Hospital, Toronto, Ont., Canada

Innominate artery rupture is a life-threatening complication of tracheal reconstructive surgery. Early postoperative rupture of the innominate artery occurred in 8 of 100 consecutive patients undergoing tracheal resection and reconstruction (93, end-to-end anastomosis; 7, Marlex prosthesis). A premonitory transient hemoptysis occurred in 4 of the 8 patients. This sign may permit early diagnosis and effective treatment. When massive hemorrhage occurs, prompt arterial compression, control of the airway, and subsequent ligation of the artery may be lifesaving. Direct repair of the arterial defect is not recommended. If the innominate artery lies in direct contact with the suture line following primary anastomosis, soft tissue interposition is recommended.




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