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An Operation for Tracheal-Innominate Artery Fistula
William O. Myers, MD;
Ben R. Lawton, MD;
Richard D. Sautter, MD
AMA Arch Surg. 1972;105(2):269-274.
Abstract
Tracheal-innominate artery fistula may have increased with the use of mechanical ventilation. Four cases were seen in 3 years in a 400-bed hospital. Low tracheostomy seemed to be a cause, and one occurred after cervical resection of tracheal stenosis. Operation for this complication failed in two cases. In the third case, axilloaxillary bypass was done first and the innominate artery ligated intrapericardially and in the supraclavicular fossa. The patient died of his primary disease six weeks later, but the tracheostomy had healed and the graft functioned until his death. Bypass is believed safe if dissection in the contaminated area is avoided and remote ligation of the artery carried out. The nature of the hemorrhage was not realized in the fourth case and the patient died. A plan for diagnosis and treatment is necessary.
Author Affiliations
Marshfield, Wis
From the Department of Thoracic and Cardiovascular Surgery, Marshfield (Wis) Clinic, and the Marshfield Clinic Foundation for Medical Research and Education.
Footnotes
Accepted for publication April 7, 1972.
Read before the 29th annual meeting of the Central Ave, Marshfield, Wis 54449 (Dr. Myers). 1972.
Reprint requests to Marshfield Clinic, 630 S Central Ave, Marshfield, Wis 54449 (Dr. Myers).
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