Trachea-innominate artery fistula: successful management of 3 consecutive patients.
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.
D000293:Adolescent; D000328:Adult; D000368:Aged; D016122:Brachiocephalic Trunk / Q000601:surgery; D001999:Bronchoscopy; D006259:Craniocerebral Trauma / Q000150:complications; D005260:Female; D005402:Fistula / Q000209:etiology* / Q000601:surgery; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D014132:Trachea; D014133:Tracheal Diseases / Q000209:etiology* / Q000601:surgery; D014140:Tracheotomy / Q000009:adverse effects*