Pericardial patch repair of an extensive longitudinal iatrogenic rupture of the intrathoracic membranous trachea

a Department of Cardio-thoracic Surgery, Larissa University Hospital, Larissa, Greece b Department of Anesthesiology, Larissa University Hospital, Larissa, Greece c Department of General Surgery, Larissa University Hospital, Larissa, Greece * Corresponding author. 35 Ioustinianou Street, 41223 Larissa, Greece. Tel.: +30-241-0287-466; fax: +30-241-061-1097 foroulis{at}internet.gr An iatrogenic, longitudinal rupture of the membranous trachea, which extended from the thoracic inlet to 2.0 cm above the carina, was found intra-operatively, during the thoracic stage of a three-stage esophagectomy, in a female, 80-year-old patient. Tracheal rupture was the result of tracheal intubation with a 35-F double-lumen endotracheal tube. Tracheal rupture was successfully repaired by suturing a free pericardial patch at the edges of tracheal rupture, by application of BioGlue on the external patch surface and by covering tracheal repair with a pedicled serratus anterior muscle flap. The patient had a 25-day intensive care unit stay and video-bronchoscopy performed at the 25th postoperative day showed absence of granulation tissue formation and an acceptable tracheal lumen. The overall hospital stay was 83 days because of abdominal complications; no problems concerning the tracheal repair were observed during the prolonged postoperative period. Key Words: Trachea; Membranous trachea wall rupture; Membranous trachea wall repair; Double-lumen endotracheal tube complications; Pericardial patch