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DOI: 10.1055/s-0031-1297642
Lateral slide tracheoplasty for complete tracheal rings with bronchus suis and pulmonary artery sling: a case report
Introduction: Pulmonary artery sling is a rare congenital heart defect in which the left pulmonary artery (LPA) originates from the right pulmonary artery (RPA) and encircles the often diseased distal trachea (complete ring with long segment obstruction). Repair using a strategy of cardiopulmonary bypass, reimplantation of the LPA and simultaneous tracheal repair is often mandatory.
Aims: We present the case of a 3 months old male with PA sling and tracheal stenosis. After the fourth week of life, recurrent infection of the upper airway and episodes of dsypnea occurred. The CT-Scan showed a very narrow complete tracheal ring, bronchus suis formation and pulmonary artery sling. A lateral slide tracheoplasty was performed in mild hypothermia on cardiopulmonary bypass. The left pulmonary artery was reimplanted anterior to the trachea into the MPA. Veno-venous ECMO was necessary for 9 days due hypercapnia post bypass, because of swelling at the tracheal anastomostic site. Patient was weaned from mechanical ventilation 13 days after operation and discharged on the 30th post-operative day.
Conclusion: Our case demonstrates that lateral slide tracheoplasty operation can be safely performed in patient with long-segment tracheal stenosis in the presence of tracheal rings. Sometimes veno-venous ECMO support is necessary to overcome temporary ventilation problems of the diseased respiratory system.