• Marco Lucchi, Marcello Ambrogi, Vittorio Aprile, Alessandro Ribechini, and Gabriella Fontanini.
• Division of Thoracic Surgery, Cardiac Thoracic and Vascular Department, University of Pisa, Italy.
• JTCVS Tech. 2020 Aug 13.

AbstractThe current COVID-19 pandemic has shown a relevant rate of patients developing an acute respiratory distress syndrome that requires hospitalization. Approximately 3-17% of hospitalized patients require Intensive Care Unit (ICU) and invasive mechanical ventilation. Initial recommendations advocated for early intubation, while early tracheotomy should not be routinely performed in COVID-19 patients. We report the case of a COVID-19 patient developing laryngo-tracheal stenosis secondary to an open surgical tracheotomy in the ICU. A conservative endoscopic management was not successful and we performed a laryngo-tracheal resection. The specimen was negative for COVID-19 but the pathological examination revealed how the virus damaged the trachea. This case is, as far as we are aware, the first case of laryngo-tracheal surgery in a COVID-19 patient and provides an insight to justify the higher rate of tracheal injuries occurring in intubated COVID-19 patients.© 2020 The Authors.

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