title: Innominate artery compression of the trachea in patients with neurological or neuromuscular disorders.
abstract: OBJECTIVE
  The purpose of this study was to review and assess our surgical management of innominate artery compression of the trachea (IACT) in patients with neurological or neuromuscular disorders (NMDs).
  
  
  METHODS
  Thirty patients with NMD who underwent surgical treatment for IACT at Kobe Children's Hospital and Kobe University Hospital from 2002 to 2012, were enrolled in this retrospective study. The clinical outcomes of preventive elective surgery for IACT (Group A, n=20) were assessed and compared with those of emergent surgery (Group B, n=10).
  
  
  RESULTS
  A total of 27 patients underwent innominate artery transection (17 in Group A and 10 in Group B), and 3 patients in Group A underwent innominate artery reimplantation using prosthetic graft interposition. No operative or early death occurred. There were no cases of postoperative mediastinitis or neurological complications. The operative benefits in Group A included a smaller skin incision, more limited sternotomy, less blood loss, shorter operative time and shorter hospital stay, compared with Group B. No blood transfusion was required in Group A. The number of patients in whom cerebral circulation was assessed before surgery in Group A was significantly higher than those in Group B.
  
  
  CONCLUSIONS
  Preventive elective surgery for IACT provides many advantages, including minimally invasive procedures and successful postoperative outcomes without neurological complications in patients with NMD. Because this surgical management can prevent the tragic occurrence of a tracheo-innominate artery fistula or an exacerbation of tracheomalacia, it would be an optimal surgical treatment for IACT to improve the quality of life in patients with NMD.
authors.affiliation: Department of Cardiovascular Surgery, Kobe Children's Hospital, Kobe, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Oshima
authors.forename: Chieko
authors.initials: C
authors.lastname: Hisamatsu
authors.forename: Hironori
authors.initials: H
authors.lastname: Matsuhisa
authors.forename: Ayako
authors.initials: A
authors.lastname: Maruo
authors.forename: Akiko
authors.initials: A
authors.lastname: Yokoi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Bitoh
authors.forename: Eiji
authors.initials: E
authors.lastname: Nishijima
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Okita
mesh_terms: D000293:Adolescent; D000328:Adult; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D016122:Brachiocephalic Trunk / Q000601:surgery*; D002560:Cerebrovascular Circulation / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D009468:Neuromuscular Diseases / Q000503:physiopathology*; D012189:Retrospective Studies; D014132:Trachea / Q000601:surgery*; D014133:Tracheal Diseases / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Innominate artery compression of the trachea; Neurological or neuromuscular disorders; Preventive elective surgery; Tracheoinnominate artery fistula; Tracheomalacia