Takiguchi Makoto, Saito Fumie, Shibairi Masao
Department of Cardiovascular Surgery, Matsudo Municipal Hospital, Matsudo, Japan.
Kyobu Geka. 2010 Feb;63(2):143-5.
Tracheo-innominate artery fistula (TIF) is one of the highly lethal complications after the tracheostomy. We report a case of successful surgical treatment of TIF 4-year after the tracheostomy due to subacute sclerosing panencephalitis. Once the bleeding was controlled by the position and the high pressure of the tracheostomy tube cuff, but was not able to be controlled 24-hour after the hospitalization. At surgery, innominate artery was clamped simply at its origin under a median sternotomy. The each side orifice of the fistula was closed directly. The thymus was interposed between the innominate artery and the trachea to prevent the infection and the re-adhesion. After surgery, the cerebral infarction due to the procedure was not detected by the brain computed tomography (CT) and also the stenosis of the innominate artery was not detected by the chest enhanced CT.
气管无名动脉瘘(TIF)是气管切开术后极具致死性的并发症之一。我们报告1例因亚急性硬化性全脑炎行气管切开术后4年成功手术治疗TIF的病例。出血一度通过气管切开套管的位置和高压得以控制,但住院24小时后无法控制。手术时,在正中胸骨切开术下,仅在无名动脉起始处予以钳夹。直接封闭瘘管的各侧孔。将胸腺置于无名动脉与气管之间以预防感染和再次粘连。术后,脑部计算机断层扫描(CT)未发现因手术导致的脑梗死,胸部增强CT也未发现无名动脉狭窄。