Abstract
Tracheo-innominate fistula (TIF) is a reported complication of
tracheostomy that typically presents with a herald bleed. The phenomenon
of an aorto-tracheal fistula has similar pathology and presentation to
TIF, but no standard surgical repair. In the manuscript by Musgrove et
al. in the Journal of Cardiac Surgery the authors propose a surgical
treatment, that is reproduceable for the correct anatomic configuration
- an ascending and aortic arch replacement, pericardial patch of the
tracheal defect, and omental flap coverage to prevent infection. While
this intervention seems a large undertaking for a small defect, it is a
safe and durable repair.