title: Effectiveness of near-infrared spectroscopy during surgical repair of tracheo-innominate artery fistula.
abstract: Monitoring regional cerebral oxygen saturation (rSO(2)) by use of near-infrared spectroscopy (NIRS) is a useful method for detecting cerebral ischemia. Tracheo-innominate artery fistula is a rare but life-threatening complication of tracheostomy. The surgical procedures for management of tracheo-innominate artery fistula include direct or patch closure of the fistula, ligation or division of the innominate artery, and anatomical or extra-anatomical reconstruction of the flow of the innominate artery. Division of the innominate artery is the best method to prevent postoperative recurrence of bleeding and infection. However, cutting off the innominate artery flow may cause brain ischemia. We present the case of a patient with tracheo-innominate artery fistula successfully treated by dividing the innominate artery while the rSO(2) was monitored. In this case report, we have shown that NIRS is a useful method for deciding the surgical maneuver for tracheo-innominate artery fistula.
authors.affiliation: Department of Cardiovascular Surgery, St. Mary's Hospital, 422 Tsubukuhon-machi, Kurume, Fukuoka, Japan. oda@st-mary-med.or.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Oda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yasunaga
authors.forename: Jun
authors.initials: J
authors.lastname: Maki
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Shimauchi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Makimoto
authors.forename: Takehito
authors.initials: T
authors.lastname: Kawakami
authors.forename: Mau
authors.initials: M
authors.lastname: Amako
authors.forename: Takahiro
authors.initials: T
authors.lastname: Shojima
authors.forename: Koji
authors.initials: K
authors.lastname: Akasu
authors.forename: Akinori
authors.initials: A
authors.lastname: Iwasaki
mesh_terms: D000293:Adolescent; D016122:Brachiocephalic Trunk / Q000601:surgery*; D005402:Fistula / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D019265:Spectroscopy, Near-Infrared; D014132:Trachea / Q000601:surgery*; D014133:Tracheal Diseases / Q000209:etiology / Q000601:surgery*; D014139:Tracheostomy / Q000009:adverse effects*; D016896:Treatment Outcome