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Innominate artery compression of the trachea in infancy and childhood: is surgical therapy justified?
Insights
Innominate artery compression can cause airway issues like stridor and apnea. Innominate arteriopexy surgery effectively treated these symptoms in children, offering a reliable, low-risk solution.
Area of Science:
- Pediatric Surgery
- Cardiovascular Surgery
- Respiratory Medicine
Background:
- Innominate artery compression of the trachea is a rare cause of pediatric airway obstruction.
- Symptoms include stridor, recurrent bronchopulmonary infections, and apneic attacks.
- Diagnosis is often confirmed via tracheobronchoscopy.
Purpose of the Study:
- To evaluate the efficacy of innominate arteriopexy in treating innominate artery compression of the trachea.
- To compare outcomes between medically treated patients and those who underwent surgery.
Main Methods:
- Retrospective review of 16 patients with innominate artery compression.
- Group I: 10 medically treated patients.
- Group II: 6 children treated with innominate arteriopexy.
Main Results:
- Apneic attacks were present in 100% of surgical patients versus 10% of medical patients.
- Innominate arteriopexy relieved reflex apnea and recurrent bronchopulmonary infections in all 6 surgically treated children.
- Tracheal stenosis was severe in all surgical patients, while medical patients had mild to moderate stenosis.
Conclusions:
- Innominate arteriopexy is a reliable and low-risk procedure for innominate artery compression.
- Surgical intervention is indicated for patients with severe tracheal stenosis and apneic attacks.
- The procedure effectively resolves apnea and reduces respiratory infections.
Abstract:
We reviewed innominate artery compression of the trachea in 10 medically treated patients (group I) and 6 children who underwent innominate arteriopexy (group II). The symptoms were as follows: (1) stridor (80% in group I, and 66% in group II), (2) recurrent bronchopulmonary infections (40% in group I, 66% in group II) and (3) apneic attacks (10% in group I and 100% in group II). Diagnosis was made in all cases by tracheobronchoscopy . It revealed severe tracheal stenosis (narrowing more than 2 thirds) in all children treated by surgery. In group I the tracheal stenosis was mild (narrowing less than one third) in 5 cases, moderate (narrowing from one third to 2 thirds) in 4 cases and severe in only one case. The indication for surgery was based on a history of apneic attacks. In this study innominate arteriopexy has proven to be a reliable and low risk procedure which relieved reflex apnea and recurrent bronchopulmonary infections in all 6 children operated upon.