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Ann Thorac Surg 2003;75:1325-1328
© 2003 The Society of Thoracic Surgeons

Case report

Management of complex tracheo-aortic fistula following neonatal tracheal reconstruction

Marco Ricci, MDa, Gordon A. Cohen, MD, PhDa, Derek Roebuck, MDa, Martin J. Elliott, MDa*

a Cardiothoracic Unit and Tracheal Team, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom

Accepted for publication September 27, 2002.

* Address reprint requests to Dr Elliott, Cardiothoracic Unit, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London WC1N 3JH, UK
e-mail: elliom1{at}gosh.nhs.uk

We describe an unusual case of tracheo-aortic fistula, which occurred after tracheal surgery and tracheal stenting. The management of this complex case and the surgical technique used for repair are discussed and illustrated. Repair of the aortic arch was accomplished using a modified technique of regional low-flow perfusion, similar to that described for neonatal aortic arch reconstruction. This strategy allowed maintenance of cerebral, myocardial, and systemic perfusion during arch repair, thus avoiding total circulatory arrest.






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Copyright © 2003 by The Society of Thoracic Surgeons.