Pneumonectomy for intractable left bronchial compression in d-transposition of the great arteries.
In infants with transposition of the great arteries (TGA) tracheobronchial obstruction may occur as a result of compression by a dilated posterior pulmonary artery, especially if there is a large interventricular septal defect with its attendant large pulmonary blood flow and high pressure. Banding of the pulmonary artery may give temporary relief. A patient with TGA had collapse of the left lung at 2 months of age, following atrial septectomy. Bronchoscopy and bronchography revealed extrinsic compression of the left main bronchus. Banding of the pulmonary artery at 6 months of age relieved the respiratory distress. At 8 years of age atelectasis of the left lung recurred following a Mustard procedure. Two additional procedures were attempted to decrease the pressure of the pulmonary artery on the bronchus but these were unsuccessful. At age 9 years, pneumonectomy, her sixth thoracotomy, was performed as a final attempt to relieve the respiratory problem caused by persistent atelectasis. She is now 17 years of age and has remained asymptomatic during the last 8 years.
D000293:Adolescent; D001982:Bronchial Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D007223:Infant; D011013:Pneumonectomy; D011651:Pulmonary Artery / Q000601:surgery; D001261:Pulmonary Atelectasis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D011859:Radiography; D014188:Transposition of Great Vessels / Q000150:complications*