[Post-intubation tracheal rupture during transcatheter aortic valve implantation]

[Post-intubation rupture of thoracic trachea in a patient with iatrogenic esophageal perforation and mediastinitis]

Iatrogenic injuries of the esophagus and trachea are rare. However, these are life-threatening events due to severe complications. The authors report iatrogenic perforation of cervical esophagus with a long false passage in posterior mediastinum in an 83-year-old patient undergoing endoscopic retrograde cholangiopancreatography for choledocholithiasis. Post-intubation rupture of thoracic trachea was diagnosed early after suturing the defect of esophagus and drainage of mediastinum. Treatment strategy was analyzed and conservative management of tracheal injury was substantiated.

[The possibilities for the prevention of incompetent tracheorrhaphy]

The present review of the literature is focused on the methods designed for the prevention of incompetent tracheorrhaphy. The main cause that dictates the necessity of strengthening the sutures is the risk of the development of the complications during the postoperative period following the surgical interventions. The incompetence of the tracheal anastomoses is known to occur in 3.6-26.3% of the patients which leads to the development of such complications as neck phlegmon, mediastinitis, and pleural empyema. The mortality rate amounts to 18.2%. The authors describe the methods employed for the prevention of incompetent tracheorrhaphy following the circular resections and suturing of the linear traumatic defects. The advantages and disadvantages of individual methods are discussed.