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Case Reports
. 2024 Apr 17;29(10):102329.
doi: 10.1016/j.jaccas.2024.102329. eCollection 2024 May 15.

Innominate Artery Pseudoaneurysm Requiring Cartilage Tracheal Repair in a Child

Claudia Villanueva  1 , Elie Sawan  1 , Ganesh Gnanappa  2 , Julian Ayer  2 , Catherine S Birman  3   4 , Alan T Cheng  3   4 , Matthew Liava'a  1
Affiliations
Case Reports

Innominate Artery Pseudoaneurysm Requiring Cartilage Tracheal Repair in a Child

Claudia Villanueva et al. JACC Case Rep. .

Abstract

Mycotic aneurysms are rare but potentially catastrophic. We report a case of an innominate artery pseudoaneurysm in a 4-year-old patient that caused a tracheoinnominate fistula requiring tracheoplasty with a costal cartilage graft and a homograft iliac artery replacement of the diseased innominate artery, with a successful outcome.

Keywords: mycotic aneurysm; pseudoaneurysm; tracheal fistula; tracheoplasty.

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Conflict of interest statement

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Large Innominate Artery Pseudoaneurysm (A) A 3-dimensional anterior view of a large innominate artery pseudoaneurysm in front of the trachea. (B) A 3-dimensional posterior view showing the close relationship of the pseudoaneurysm with the trachea. Asc = ascending; LCC = left common carotid artery; LIV = left innominate vein; RBCA = right brachiocephalic artery; RCC = right common carotid artery; RIJ = right internal jugular vein; RSCA = right subclavian artery.
Figure 2
Figure 2
Mycotic Aneurysm of the Innominate Artery (A) Axial view of the innominate mycotic aneurysm anterior to the trachea. The surrounding hematoma is also noted (red star). (B) Sagittal view showing displacement of the trachea with the endotracheal tube posterior to the pseudoaneurysm.
Figure 3
Figure 3
Tracheal Defect The trachea had dehisced anteriorly, creating a large defect.
Figure 4
Figure 4
Costal Cartilage Graft The cartilage graft is shaped into a keel.
Figure 5
Figure 5
Parachute Technique Graft is parachuted down to the trachea.
Figure 6
Figure 6
Homograft Iliac Artery A distal ascending aorta–to–right common carotid artery bypass is shown.
Figure 7
Figure 7
Laryngobronchoesophagoscopy Granulation tissue at the repair site and a patent trachea are shown.
See this image and copyright information in PMC

References

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