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Tracheo-innominate Artery Fistula in Children with High-Lying Innominate Artery

Division of Cardiovascular Thoracic Surgery, Department of Surgery, Songklanagarind Hospital, Songkla, Thailand

For reprint information contact: Voravit Chittithavorn, MD Tel: 66 74 451 401 Fax: 66 74 429 384 Email: Cvoravit{at}medicine.psu.ac.th, Division of Cardiovascular Thoracic Surgery, Department of Surgery, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University, Hatyai, Songkla 90110, Thailand.

Tracheo-innominate artery fistula (TIF) is an uncommon but frequently fatal complication of tracheostomy. Significant airway hemorrhage usually occurs after premonitory bleeding. When massive bleeding occurs, immediate control of arterial bleeding, control of the airway and subsequent definite treatment are the principles for saving lives. Without prompt surgical intervention, the outcome of this complication is grave. Physicians should maintain a high index of suspicion of TIF in any patient with a recent tracheostomy and subsequent tracheal hemorrhage.