Prevention of Tracheo-Innominate Artery Fistula Formation as a Complication of Tracheostomy: Two Case Reports

Tracheo-innominate artery fistula (TIF) is a rare complication of tracheostomy and refers to the formation of a fistula between the trachea and innominate artery. Because TIF is fatal, prevention rather than treatment is very important. Here we report the cases of two high-risk patients who underwen...

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Bibliographic Details
Published in:Children (Basel) 2022-10, Vol.9 (11), p.1603
Main Authors: Yoo, Byungsun, Lee, Bongjin, Park, June Dong, Kwon, Seong Keun, Kwak, Jae Gun
Format: Article
Language:English
Subjects:
Care and treatment
Case Report
Case reports
Comparative analysis
Complications and side effects
Disease prevention
Fistula
Hospitalization
innominate artery
Intubation
Life expectancy
muscular dystrophy
omphalocele
Ostomy
Patients
Pediatrics
Pneumothorax
Prevention
Pulmonary arteries
Scoliosis
Surgery
trachea
Tracheostomy
Tracheotomy
Transplantation of organs, tissues, etc
Vascular fistula
Veins & arteries
Ventilators
Weaning
Wound healing
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Summary:Tracheo-innominate artery fistula (TIF) is a rare complication of tracheostomy and refers to the formation of a fistula between the trachea and innominate artery. Because TIF is fatal, prevention rather than treatment is very important. Here we report the cases of two high-risk patients who underwent tracheostomy, and in whose cases attempts were made to lower the risk of TIF. In the first patient who developed a chest deformity with Duchenne muscular dystrophy, a tracheostomy was performed with a high-level (cricothyroid level) approach compared with the standard tracheostomy. In the second patient, the thoracic cage was relatively small due to a giant omphalocele, and the risk of a fistula forming was decreased by wrapping the innominate artery with an opened polytetrafluoroethylene vascular graft after resolving crowding of the intrathoracic cavity by total thymectomy. There was no TIF occurrence at the outpatient follow-up in either case. We expect that our approaches may be effective intervention measures for preventing TIF.
ISSN:2227-9067
2227-9067
DOI:10.3390/children9111603