Abstract
Tracheoinnominate artery fistula is a relatively rare but often life- threatening complication of tracheostomy. We successfully treated a case of 15-year-old boy complicated with tracheoinnominate artery fistula following tracheostomy. He had suffered from cerebral palsy and severe scoliosis and was forced to be under mechanical ventilation with tracheostomy because of progressive respiratory deterioration. TracheoSoft® was used with a cuff positioned at the lower trachea to overcome the tracheomalacia. Two months after tracheotomy, sudden massive hemorrhage occurred through the tracheostoma. Continuing cardiopulmonary resuscitation, we succeeded in controlling the hemorrhage by adjusting the position of an overinflated tracheal tube cuff. After bedside control of hemorrhage, prompt operation with a division of innominate artery was performed. His postoperative course was uneventful, and he was discharged from intensive care unit on the 6th postoperative day. We may have to plan a preventive operation with a division of innominate artery for a patient with many risk factors for the development of tracheoinnominate artery fistula.
