The left anterior extrapleural approach for innominate artery transection in a patient with tracheostomy and a neurological disorder.

Although innominate artery transection for innominate artery compression of the trachea is recently used for prevention of life-threatening complications (e.g. massive bleeding and obstructive apnoea) in patients with neurological disorders, pre-existing tracheostomy poses a risk of mediastinal infection with sternotomy. We successfully performed innominate artery transection on such a patient via the left anterior extrapleural approach without sternotomy after confirming the anatomical configuration on three-dimensional multidetector row computed tomography angiography.