Treating tracheo-innominate artery fistula with interposition of a pectoralis major myocutaneous flap.

Tracheo-innominate artery fistula (TIF) is an uncommon life-threatening complication of tracheostomy. A prompt diagnosis and surgical intervention can save the life of a TIF patient. Several methods of reconstructing the tracheal defect have been reported, but may not be available in the presence of extensive infection. We used a trough and pectoralis major myocutaneous flap to treat a TIF patient with a large tracheal defect and severe infection who had to be ventilated mechanically. This may be a useful option in the treatment of this rare, devastating complication of tracheostomy.