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Title
1. Introduction
2. Diagnostic Bronchoscopy
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a. Identify the Level of Tracheal Obstruction
3. Exposure and Surgical Approach
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a. Thoracotomy Incision Made in the Third Right Anterior Intercostal Space
b. Pectoral Muscles Incised Medially and Split Towards Lateral End of Incision
c. Chest Entered and Internal Mammary Vessels Divided and Ligated at Medial End of Incision
d. Chest Retractor Placed to Widen Incision; Lung is Retracted by Moist Wet Sponge
e. Thymus is Mobilized Away from the Superior Vena Cava (on the right) Taking Care not to Injure the Phrenic Nerve
f. The Ipsilateral Thymic Lobe is Resected to Expose the Innominate Artery and Vein and the Aorta
g. Ipsilateral Pericardium is Incised and Opened to Expose Roots of Great Vessels
4. Optimal Site for Placement of Aortopexy Sutures
5. Placement of Sutures in Aorta
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a. Under Direct Bronchoscopy Sutures are Tied Down to Approximate the Innominate Artery to the Sternum
6. Closure
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Aortopexy for Innominate Artery Compression of the Trachea
Andrew Scott, MD
;
Carl-Christian A. Jackson, MD
;
Walter Chwals, MD
Tufts University School of Medicine
Tags:
General Surgery
Pediatric Surgery
Vascular Surgery
Cardiac Surgery
Thoracic Surgery
Pulmonology
Main Text
Procedure Outline
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Authors
Andrew Scott, MD
Carl-Christian A. Jackson, MD
Walter Chwals, MD
Filmed At:
Tufts University School of Medicine
Article Information
Publication Date
9/24/2024
Article ID
10
Production ID
0055
Volume
2024
Issue
10
DOI
https://doi.org/10.24296/jomi/10