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Eur J Cardiothorac Surg 2009;36:214-216. doi:10.1016/j.ejcts.2009.03.043
Copyright © 2009, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Case reports

Tracheoinnominate artery fistula caused by migration of a Kirschner wire

Yi-Hsuan Wua,1, Chao-Han Laia,b,1, Chawn-Yau Luoa, Yau-Lin Tsenga,b,*

a Department of Surgery, National Cheng Kung University Hospital and Dou-liou Branch, Tainan, Taiwan
b Institute of Clinical Medicine, Medical College, National Cheng Kung University, Tainan, Taiwan

Received 4 January 2009; received in revised form 19 March 2009; accepted 24 March 2009.

* Corresponding author. Address: Department of Surgery, National Cheng Kung University Hospital, 138, Sheng-Li Road, Tainan 704, Taiwan. Tel.: +886 6 2353535x5187; fax: +886 6 2766676. (Email: tsengyl{at}mail.ncku.edu.tw).

Iatrogenic injury is an underreported but potentially devastating complication of orthopedic wire migration. We report a 48-year-old man with a tracheoinnominate artery fistula caused by migration of a Kirschner wire that was inserted for fixation of a left clavicle fracture nine years before. Following surgical removal of the wire and repair of both trachea and innominate artery, the patient recovered eventually. Although migration of orthopedic wire to the trachea has been reported twice in previous literature, such a complication involving both the trachea and arch vessel was not previously described. Physicians who care for patients with orthopedic wires in place should be aware of migration with tracheoinnominate artery fistula and other iatrogenic injuries as potentially lethal complications.

Key Words: Trachea • Innominate artery • Tracheoinnominate artery fistula • Kirschner wire migration






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Copyright © 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.