A series of 16 patients with tracheal compression by the innominate artery is presented. In more than half of the patients the symptoms began during the first few days of life with stridor of varying severity, recurrent tracheobronchitis and apneic spells. In six cases requiring surgical treatment the immediate result was good. In ten mild cases treatment consisted of medical management and follow-up. The present study confirms that the great arteries can exert severe compression on the trachea, which can always be relieved by means of an operation which moves the arteries forward. Bronchoscopy is considered to be the only reliable means of diagnosis. This entity should be considered more often in the differential diagnosis in children less than 3 years of age with stridor, breathing difficulties, recurrent infections, apneic spells, and asthma.
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