title: Avoidance of a potential tracheoinnominate fistula by innominate artery re-implantation in a four year old girl with tracheostomy dependence and Pfeiffer syndrome.
abstract: A 4 year old tracheostomy dependent girl with Pfeiffer syndrome was noted on bronchoscopy to have a pulsatile tracheostomal mass. CT chest angiography was consistent with the innominate artery crossing anterior to the trachea and superior to the sternal notch. The patient underwent reimplantation of the innominate artery via a median sternotomy approach. Tracheoinnominate fistula is a potentially devastating complication of tracheostomy. We report discovery of a near tracheoinnominate fistula in order to highlight the importance of regular interval surveillance endoscopy in tracheostomy dependent children and to discuss a preventative surgical intervention employed in prevention of this potentially devastating complication.
authors.affiliation: Mayo Clinic, Department of Otolaryngology, Rochester, MN, United States. Electronic address: olson.michael@mayo.edu.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Olson
authors.affiliation: Mayo Clinic, Department of Pediatrics and Adolescent Medicine, Rochester, MN, United States. Electronic address: boesch.paul@mayo.edu.
authors.forename: R Paul
authors.initials: RP
authors.lastname: Boesch
authors.affiliation: Mayo Clinic, Department of Vascular Surgery, Rochester, MN, United States. Electronic address: duncan.audra@mayo.edu.
authors.forename: Audra A
authors.initials: AA
authors.lastname: Duncan
authors.affiliation: Mayo Clinic, Otolaryngology, Rochester, MN, United States. Electronic address: cofer.shelagh@mayo.edu.
authors.forename: Shelagh A
authors.initials: SA
authors.lastname: Cofer
mesh_terms: D000168:Acrocephalosyndactylia / Q000150:complications* / Q000601:surgery; D000792:Angiography; D016122:Brachiocephalic Trunk / Q000473:pathology / Q000601:surgery*; D001999:Bronchoscopy; D002675:Child, Preschool; D005260:Female; D005402:Fistula / Q000517:prevention & control* / Q000601:surgery; D006801:Humans; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000601:surgery; D014133:Tracheal Diseases / Q000150:complications* / Q000601:surgery; D014139:Tracheostomy
keywords: Complication; Morbidity; Tracheoinnominate fistula; Tracheostomy