What question did this study set out to answer?

This report aims to present a rare case of complete thoracic inlet tracheal transection and its surgical management using VV-ECMO support.

March 14, 2026Open Access

Complete tracheal transection at the thoracic inlet: successful reconstruction with intraoperative Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO) support – case report

Key Points

This report aims to present a rare case of complete thoracic inlet tracheal transection and its surgical management using VV-ECMO support.
Documented the tracheal injury due to blunt chest trauma.
Conducted surgical reconstruction with pre-positioned VV-ECMO cannulas.
Initiated VV-ECMO during surgery due to oxygenation decline.
Patient sustained cardiac arrest for 2 minutes but was successfully resuscitated.
Surgery was completed under sustained VV-ECMO support.
Postoperative recovery was satisfactory.

Abstract

Tracheobronchial injuries from blunt chest trauma carry high mortality, with complete thoracic inlet tracheal transection being previously undocumented. While Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO) has been increasingly recognized as a critical airway support modality in traumatic tracheal reconstruction, current evidence provides no consensus regarding optimal ECMO initiation timing in surgical decision-making. A 58-year-old male driver sustained front and back chest impacts in a crash. CT scan revealed complete tracheal transection at the thoracic inlet (mimicking a “bitten-off” appearance). With a dedicated VV-ECMO team on standby, we expeditiously commenced tracheal repair surgery. Intraoperatively, refractory oxygenation deterioration prompted immediate initiation of VV-ECMO via pre-positioned cannulas. Despite this intervention, the patient experienced a 2-minute cardiac arrest, which was successfully reversed. The procedure was ultimately completed with sustained VV-ECMO support, and the patient achieved satisfactory postoperative recovery. This case demonstrates a unique traumatic tracheal injury mechanism and highlights the critical role of preemptive VV-ECMO team activation in managing complex airway reconstruction.

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Cite This Study

Luo et al. (Wed,) studied this question.

synapsesocial.com/papers/69b4fa9ab39f7826a300b4cf https://doi.org/https://doi.org/10.1186/s12245-026-01162-9

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