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Ann Thorac Surg 1977;24:439-447
© 1977 The Society of Thoracic Surgeons

Articles

Trachea–Innominate Artery Fistula: Successful Management or 3 Consecutive Patients

Joel D. Cooper, M.D.

Division of Thoracic Surgery, 1-131 University Wing, Toronto General Hospital, Toronto, Ont, Canada M56-1L7.

Trachea-innominate artery fistula is an uncommon but frequently fatal complication of tracheostomy. Three successive patients who developed this complication while receiving ventilatory assistance through a tracheostomy tube were successfully managed, with long-term survival. Bleeding was controlled by direct digital pressure on the innominate artery or by hyperinflation of the balloon cuff of the tracheostomy tube. In 2 patients, replacement of the tracheostomy tube with an orotracheal tube improved direct access to the innominate artery for digital compression. Late follow-up examination of the right carotid circulation revealed complete reversal of flow in the right internal and common carotid arteries in the 2 patients studied.




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