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Level 3 tracheal injury in acute coronary syndrome treated conservatively with extracorporeal membrane oxygenation
  1. Syuntaro Horio,
  2. Takashi Yoshizane,
  3. Makoto Iwama and
  4. Toshiyuki Noda
  1. Cardiology, Gifu Prefectural General Medical Center, Gifu, Gifu, Japan
  1. Correspondence to Dr Takashi Yoshizane; takashiyoshizane{at}


Level 3 tracheal injury, characterised by complete laceration with oesophageal or mediastinal soft-tissue herniation, is conventionally indicated for surgical repair. We present the case of a woman in her 60s with level 3 tracheal injury in acute coronary syndrome who was treated successfully without surgery. Venoarterial extracorporeal membrane oxygenation (ECMO) was introduced during lung-rest management to avoid positive pressure ventilation, and percutaneous coronary angioplasty was performed. Venoarterial ECMO was switched to venovenous ECMO when the haemodynamics improved. The tracheal injury healed spontaneously in 10 days, and ECMO was withdrawn on day 15. The patient made full recovery and was discharged on day 51.

  • Adult intensive care
  • Mechanical ventilation
  • Ischaemic heart disease

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  • Contributors Supervised by TN. Patient was under the care of SH, TY and MI. Report was written by TY.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.