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Innominate artery compression of the trachea in infants with reflex apnea
Insights
Anomalous innominate artery can compress the infant trachea, causing respiratory arrest. Surgical correction via innominate arteriopexy is an effective treatment, especially for infants experiencing reflex apnea.
Area of Science:
- Pediatric Surgery
- Cardiovascular Surgery
- Respiratory Medicine
Background:
- Tracheal compression in infants can lead to respiratory arrest.
- An anomalous innominate artery is a known cause of such compression.
- Reflex apnea is frequently associated with this condition.
Purpose of the Study:
- To review the syndrome of tracheal compression by an anomalous innominate artery.
- To evaluate the effectiveness of innominate arteriopexy in managing this condition.
- To delineate indications for surgical correction.
Main Methods:
- Retrospective review of 78 pediatric patients managed between 1977 and 1979.
- Analysis of patient histories, focusing on reflex apnea episodes.
- Surgical intervention through innominate arteriopexy.
Main Results:
- Innominate arteriopexy was performed on 28 patients with a history of reflex apnea.
- The surgical management proved highly effective.
- The study identified and discussed other indications for surgical intervention.
Conclusions:
- Reflex apnea is a clear indication for surgical correction of anomalous innominate artery causing tracheal compression.
- Innominate arteriopexy is an effective treatment for this pediatric respiratory condition.
- Further indications for surgical management were identified and are discussed.
Abstract:
Compression of the trachea by an anomalous innominate artery in association with reflex apnea is a frequent cause of respiratory arrest in infants. Once considered, tracheoscopy is mandatory to rule out this disorder. Surgical correction of this condition by innominate arteriopexy has proven to be a very effective method of management. Seventy-eight patients with tracheal compression by an anomalous innominate artery managed by the authors at The Children's Memorial Hospital in Chicago between January 1977 and December 1979 are presented. In this series, 28 patients had a history of one or more episodes of reflex apnea; all of these patients underwent an innominate arteriopexy. A complete review of this syndrome and methods of its diagnosis are scrutinized. We agree with previous authors that reflex apnea is a definite indication for surgical correction of this vascular anomaly causing tracheal compression, but other indications are delineated.