Tracheo-innominate artery fistula (TIF) is one of the highly lethal complications after the tracheostomy. We report a case of successful surgical treatment of TIF 4-year after the tracheostomy due to subacute sclerosing panencephalitis. Once the bleeding was controlled by the position and the high pressure of the tracheostomy tube cuff, but was not able to be controlled 24-hour after the hospitalization. At surgery, innominate artery was clamped simply at its origin under a median sternotomy. The each side orifice of the fistula was closed directly. The thymus was interposed between the innominate artery and the trachea to prevent the infection and the re-adhesion. After surgery, the cerebral infarction due to the procedure was not detected by the brain computed tomography (CT) and also the stenosis of the innominate artery was not detected by the chest enhanced CT.
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