Innominate Pseudoaneurysm Subtotally Compressing the Trachea as a Result of Blunt Trauma

Blunt traumatic innominate pseudoaneurysm is rare, and coexisting airway distress is even rarer. We describe a case of innominate pseudoaneurysm that subtotally compressed the trachea in a 45-year-old man. The patient also had bovine-type arch anatomy. He experienced exacerbated respiratory distress on anesthesia induction. A cardiopulmonary bypass (CPB) circuit was immediately established through the femoral vessels. The aortic arch was replaced with a branched graft under circulatory arrest and antegrade cerebral perfusion. The pseudoaneurysm was eliminated and airway compression was completely relieved. The patient fully recovered without major complications. The unique feature of this case is its association with airway compression, which is uncommon but potentially lethal.