Saudi Critical Care Journal

CASE REPORT
Year
: 2021  |  Volume : 5  |  Issue : 1  |  Page : 7--9

Tracheoinnominate fistula due to high-riding innominate artery: A rare but potentially life-threatening complication following long-term tracheostomy


Bhushan Sudhakar Wankhade1, Ammar Mohamed Abdel Hadi1, Zeyad Faoor Alrais1, Gopala Arun Kumar Naidu1, Hossameldin Eid2 
1 Department of Surgical Intensive Care, Rashid Hospital, Duba, UAE
2 Department of Cardiothoracic Surgery, Dubai Hospital, Duba, UAE

Correspondence Address:
Bhushan Sudhakar Wankhade
Surgical Intensive Care Unit, Rashid Hospital, Oud Metha, P.O. Box: 4545, Dubai
UAE

Tracheoinnominate fistula (TIF) is a rare but potentially life-threatening complication after tracheostomy. TIF was mostly observed within 7–21 days after tracheostomy but can present even years after tracheostomy. The risk factors for TIF are high cuff pressure, mucosal trauma from malpositioned cannula tip, low tracheal incision, excessive neck movement (hyperextension), radiotherapy, prolonged intubation, and high-riding innominate artery (HRIA). HRIA is also a rare anatomical variation of the innominate artery (IA) whereas IA bifurcates above the sternoclavicular joint. We report a rare case of TIF in a patient with HRIA, who presented with airway bleeding 2 months after percutaneous tracheostomy (PT) and was successfully managed with aggressive resuscitation and midline sternotomy. Knowledge of anatomical variation of the aortic arch and its major branches is essential for the physician who is routinely performing or managing tracheostomy. All the health-care workers involved in the management of tracheostomy should bear this complication in mind while dealing with any airway bleed. We recommend the routine use of bedside neck ultrasonography before all PTs to locate any aberrant vessel within the vicinity of tracheostoma to prevent this complication.


How to cite this article:
Wankhade BS, Abdel Hadi AM, Alrais ZF, Kumar Naidu GA, Eid H. Tracheoinnominate fistula due to high-riding innominate artery: A rare but potentially life-threatening complication following long-term tracheostomy.Saudi Crit Care J 2021;5:7-9


How to cite this URL:
Wankhade BS, Abdel Hadi AM, Alrais ZF, Kumar Naidu GA, Eid H. Tracheoinnominate fistula due to high-riding innominate artery: A rare but potentially life-threatening complication following long-term tracheostomy. Saudi Crit Care J [serial online] 2021 [cited 2021 May 14 ];5:7-9
Available from: https://www.sccj-sa.org/article.asp?issn=2543-1854;year=2021;volume=5;issue=1;spage=7;epage=9;aulast=Wankhade;type=0