Operative technique for repair of tracheoinnominate artery fistula.

Tracheoinnominate artery fistula is a relatively rare but highly lethal complication for long-term tracheostomy patients that occurs with an estimated incidence of 1 out of every 150 tracheostomies performed. Appropriate operative technique during tracheostomy and meticulous postoperative care usually prevent this devastating lesion. When tracheoinnominate fistula is suspected, immediate evaluation under general anesthesia in the operating suite, followed by prompt thoracotomy and repair, is essential for the survival of these patients.