Document Detail

Tracheo-arterial fistula in tracheostomy patients with Duchenne muscular dystrophy.
MedLine Citation:
PMID:  16368206     Owner:  NLM     Status:  MEDLINE    
A tracheo-arterial fistula is a serious and life threatening potential complication of a tracheostomy. Since 1984, we experienced nine fatal cases of tracheo-arterial fistula among 60 Duchenne muscular dystrophy (DMD) patients who underwent a tracheostomy. Representative cases included a patient with lordosis (Case 8), in whom the fistula was located in the brachiocephalic artery close to the trachea, and another with severe scoliosis (Case 9), which caused the aorta to compress the trachea. Such anatomical changes can be the cause of a fistula between the trachea and brachiocephalic artery. The anatomical locations between the trachea and brachiocephalic artery are modified by thoracic deformities in DMD patients, and should be confirmed using computed tomography (CT) prior to a tracheostomy procedure. Further, during such a procedure, the tracheal stoma must be placed in a location clearly away from the arteries, and should be followed by regular post-operative examinations using CT and careful management to avoid a tracheo-arterial fistula.
Toshio Saito; Noriyoshi Sawabata; Tsuyoshi Matsumura; Sonoko Nozaki; Harutoshi Fujimura; Susumu Shinno
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-12-20
Journal Detail:
Title:  Brain & development     Volume:  28     ISSN:  0387-7604     ISO Abbreviation:  Brain Dev.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-03-17     Completed Date:  2006-06-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7909235     Medline TA:  Brain Dev     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  223-7     Citation Subset:  IM    
Division of Neurology, National Hospital Organization Toneyama National Hospital, 5-1-1 Toneyama, Toyonaka, Osaka 560-8552, Japan.
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MeSH Terms
Brachiocephalic Trunk / injuries,  pathology,  physiopathology
Fatal Outcome
Muscular Dystrophy, Duchenne / complications*
Patient Selection
Postoperative Complications / etiology,  physiopathology,  prevention & control
Postoperative Hemorrhage / etiology*
Preoperative Care / standards
Respiratory Insufficiency / etiology,  surgery*
Respiratory Tract Fistula / etiology*,  pathology,  physiopathology
Tomography, X-Ray Computed / standards
Trachea / injuries*,  radiography,  surgery
Tracheostomy / adverse effects*,  mortality

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