Case of the Week: May 31-June 7, 2007

7 year old with history of asthma

(Click for a larger image.)











Case Details

Narrowing of the trachea anteriorly at the thoracic inlet secondary to innominate artery compression.

Answer

Diagnosis: INNOMINATE ARTERY COMPRESSION SYNDROME

Likely related to lack of rigidity of the infantile cartilage of trachea.

Spectrum of severity from severe narrowing with symptoms to asymptomatic.

Symptoms include stridor, apnea, dyspnea. Symptoms will typically resolve as the child grows. 

Infant's innominate artery arises from aortic arch more to the left than it does in adults. 

Surgical therapy is controversial and reserved for those with severe symptoms and who fail conservative management. 

Aortopexy and re-implantation of innominate artery origin.

Correct answers by users

VCU Resident
Radiology Pediatrics
Others
  • Arash ChehraziUnited States of America
  • Jeffrey VandeSandUnited States of America
    VCU Department of Pediatric Radiology Virginia Commonwealth University VCU Medical Center