Oshima Y, Yamaguchi M, Hosokawa Y, Ohashi H, Nishikawa Y, Tsubota N
Nihon Kyobu Geka Gakkai Zasshi. 1989 Mar;37(3):535-9.
Congenital cardiac anomaly combined with severe obstructive lesion of airway remains a surgical challenge. A case of 5-year old child with tetralogy of Fallot associated with congenital tracheal stenosis (cartilagenous ring) was reported. The patient had history of cyanosis and stridor since age 3 months and had been hospitalized repeatedly for recurrent respiratory distress. The diagnosis was first established and emergent Blalock-Taussig shunt was carried out during first admission at age 1 year and 7 months. On the fourth admission at age 5 year, a definitive surgical intervention was decided following re-evaluation of the patient by cardiac catheterization, bronchoscopy and bronchography. Trachea and heart were exposed through cervical collar and presternal skin incision and median sternotomy. Tracheal resection and end-to-end anastomosis combined with total correction of tetralogy of Fallot was carried out under cardiopulmonary bypass. Utmost care was paid to avoid contamination during the operation. He was extubated at 9th postoperative day and has been free from symptom 9 months after the operation.
