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Innominate Artery Compression Syndrome: A Real Entity.

Timothy W Pettitt^1,2, Matthew Nungesser², Adele K Evans^2,3

¹Division of Pediatric Cardiothoracic Surgery, Children's Hospital New Orleans, LCMC Health, New Orleans, Louisiana.

Annals of Thoracic Surgery Short Reports

|January 10, 2025

Summary

Innominate artery compression syndrome can cause severe airway issues in children, hindering tracheostomy decannulation. Surgical translocation of the innominate artery successfully relieved tracheal compression, enabling decannulation.

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Area of Science:

Pediatric Surgery
Thoracic Surgery
Vascular Anomalies

Background:

Extrinsic lower airway compression in children is frequently caused by vascular anomalies.
Innominate artery compression syndrome (IACS) is a specific type of anterior tracheal compression due to aberrant innominate artery anatomy.

Observation:

A 6-year-old child with a history of neonatal congenital diaphragmatic hernia repair, coarctation of the aorta repair, tracheostomy, and ventilator dependence presented with severe tracheal compression.
The patient's pulmonary hypoplasia and tracheobronchomalacia complicated management and precluded tracheostomy decannulation.

Findings:

The child was diagnosed with innominate artery compression syndrome causing significant tracheal compression.
Surgical intervention involving innominate artery translocation and aortopexy successfully decompresssed the trachea.

Implications:

This surgical approach achieved adequate tracheal decompression, allowing for tracheostomy decannulation.
Innominate artery translocation is an effective treatment for IACS, potentially avoiding the need for tracheoplasty.