title: Minimally invasive innominate artery transection for tracheomalacia using 3-dimensional multidetector-row computed tomographic angiography: report of a case.
abstract: We successfully performed transection of the innominate artery in a patient with a neuromuscular disorder through minimally invasive access after confirming the anatomical relationships of the vessel using 3-dimensional multidetector-row computed tomographic angiography. A 16-year-old girl with spinal muscular atrophy type 1 had been on long-term mechanical ventilation with a tracheostomy. She had scoliosis and tracheomalacia. Bronchoscopy showed a flattened and narrow lower trachea and an anterior pulsatile compression by the innominate artery. She underwent transection of the innominate artery to prevent tracheoinnominate artery fistula formation. Based on preoperative 3-dimensional multidetector-row computed tomographic angiography images, the innominate artery was transected through a small transverse curvilinear skin incision just below the suprasternal notch and an oblique partial manubriotomy from the suprasternal notch to the first left intercostal space.
authors.affiliation: Division of Cardiovascular and Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan. thase428@med.kobe-u.ac.jp
authors.forename: Tomomi
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Azusa
authors.initials: A
authors.lastname: Zaima
authors.forename: Chieko
authors.initials: C
authors.lastname: Hisamatsu
authors.forename: Eiji
authors.initials: E
authors.lastname: Nishijima
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Okita
mesh_terms: D000293:Adolescent; D000792:Angiography / Q000295:instrumentation*; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D019060:Minimally Invasive Surgical Procedures; D012600:Scoliosis / Q000150:complications; D014897:Spinal Muscular Atrophies of Childhood / Q000150:complications; D014057:Tomography, X-Ray Computed; D055090:Tracheomalacia / Q000209:etiology / Q000601:surgery*