Li Meng-Ju, Wang Ching-Chia, Chen Shye-Jye, Chiu Shuenn-Nan, Wu En-Ting, Wang Jou-Kou, Wu Mei-Hwan
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan.
Eur J Pediatr. 2009 Mar;168(3):351-3. doi: 10.1007/s00431-008-0748-4. Epub 2008 May 28.
Tracheobronchial compression by cardiovascular structures complicates the course after surgery of congenital heart disease. A 2-month-old boy with ventricular septal defect, pulmonary atresia, and velocardiofacial syndrome had severe left main bronchus obstruction due to external compression by an anomalously oriented ascending aorta. The patient's hypoxemic episodes necessitated extracorporeal membrane oxygenation. We inserted a stent in the left bronchus to open the airway, but the stent was crushed by the anomalous aorta. We later surgically rerouted the aorta and finally restored the patency of the left main bronchus. However, the patient died of fungemia, without being weaned from extracorporeal membrane oxygenation. We conclude that surgery is necessary instead of stent implantation to relieve the external compression of the left bronchus from a vessel with systemic arterial pressure.
心血管结构对气管支气管的压迫使先天性心脏病手术后的病程复杂化。一名患有室间隔缺损、肺动脉闭锁和腭心面综合征的2个月大男孩，因异常走行的升主动脉外部压迫导致严重的左主支气管梗阻。患者的低氧血症发作需要体外膜肺氧合。我们在左支气管中置入了一个支架以开通气道，但该支架被异常的主动脉压扁。我们后来通过手术重新调整了主动脉的走行，最终恢复了左主支气管的通畅。然而，患者死于真菌血症，未能撤掉体外膜肺氧合。我们得出结论，对于解除来自具有体动脉压力的血管对左支气管的外部压迫，手术而非支架植入是必要的。
