title: The left anterior extrapleural approach for innominate artery transection in a patient with tracheostomy and a neurological disorder.
abstract: Although innominate artery transection for innominate artery compression of the trachea is recently used for prevention of life-threatening complications (e.g. massive bleeding and obstructive apnoea) in patients with neurological disorders, pre-existing tracheostomy poses a risk of mediastinal infection with sternotomy. We successfully performed innominate artery transection on such a patient via the left anterior extrapleural approach without sternotomy after confirming the anatomical configuration on three-dimensional multidetector row computed tomography angiography.
authors: Department of Cardiovascular Surgery, Kobe Children's Hospital, Kobe, Japan tohasegawa_kch@hp.pref.hyogo.jp.
authors: Tomomi
authors: T
authors: Hasegawa
authors: Department of Cardiovascular Surgery, Kobe Children's Hospital, Kobe, Japan.
authors: Yoshihiro
authors: Y
authors: Oshima
authors: Department of Pediatric Surgery, Kobe Children's Hospital, Kobe, Japan.
authors: Yuko
authors: Y
authors: Bitoh
authors: Department of Cardiovascular Surgery, Kobe Children's Hospital, Kobe, Japan.
authors: Ryuma
authors: R
authors: Iwaki
mesh_terms: D000402:Airway Obstruction / Q000517:prevention & control; D000792:Angiography / Q000379:methods; D001720:Birth Injuries / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging / Q000601:surgery*; D002648:Child; D004636:Emergency Service, Hospital; D005500:Follow-Up Studies; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications / Q000175:diagnosis; D021621:Imaging, Three-Dimensional; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009422:Nervous System Diseases / Q000150:complications / Q000175:diagnosis; D056888:Patient Positioning; D010994:Pleura / Q000601:surgery; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods; D012131:Respiratory Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D013530:Surgical Wound Infection / Q000517:prevention & control; D013908:Thoracotomy / Q000379:methods*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D014139:Tracheostomy / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*
keywords: Innominate artery transection; Left anterior extrapleural approach; Neurological disorder