Successful surgical management of tracheo-innominate artery fistula

A 7-year-old boy with tetralogy of Fallot underwent a cardiac operation. A tracheostomy was performed for respiratory failure 8 months after the operation. After 10 months of tracheostomy, a cuffed tracheal canula was used, because of aspiration of salviva. After 1 month, the patient developed massive hemorrhage from his tracheostoma. Hemorrhage was controlled by hyperinflation of the cuff. At operation, the innominate artery was ligated at its aortic origin and at its bifurcation. The tracheal defect was repaired with a muscle flap.