Innominate artery compression of the trachea. A simplified technique for anterior suspension of the innominate artery.
OBJECTIVE
When innominate artery compression of the trachea causes airway obstruction in infancy, the standard treatment is anterior suspension of the innominate artery by anchoring it to the back of the sternum to relieve the pressure on the trachea, known as aortotruncopexy. We describe a simplified technique for anterior suspension of the innominate artery, by suturing the pretracheal fascia to the back of the manubrium.


METHODS
We have used this technique in three infants with follow-up to eighteen months.


METHODS
University teaching hospital, regional paediatric and cardiac surgical centre.


METHODS
Three infants presenting with intractable respiratory difficulties, principally caused by the innominate artery compression of the trachea.


METHODS
All patients underwent right thoracotomy. The innominate artery was lifted away from the trachea by creating a pretracheal fascial sling attached to the back of the manubrium.


METHODS
Clinical follow-up.


RESULTS
All patients have shown improvement in symptoms and none has required further hospitalization.


CONCLUSIONS
This technique appears to give satisfactory results and may reduce the risk of complications, compared with more elaborate operations.
Kamerkar
D R
DR
Department of Cardiac Surgery, Royal Victoria Hospital, Belfast, North Ireland.
Gladstone
D J
DJ
D016122:Brachiocephalic Trunk / Q000002:abnormalities / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D013536:Suture Techniques; D014135:Tracheal Stenosis / Q000209:etiology* / Q000601:surgery*