Innominate Artery Compression of the Trachea in Infants with Reflex Apnea

Abstract

Compression of the trachea by an anomalous innominate artery in association with reflex apnea is a frequent cause of respiratory arrest in infants. Once considered, tracheoscopy is mandatory to rule out this disorder. Surgical correction of this condition by innominate arteriopexy has proven to be a very effective method of management. Seventy-eight patients with tracheal compression by an anomalous innominate artery managed by the authors at The Children's Memorial Hospital in Chicago between January 1977 and December 1979 are presented. In this series, 28 patients had a history of one or more episodes of reflex apnea; all of these patients underwent an innominate arteriopexy. A complete review of this syndrome and methods of its diagnosis are scrutinized. We agree with previous authors that reflex apnea is a definite indication for surgical correction of this vascular anomaly causing tracheal compression, but other indications are delineated.