Right-sided aortic arch presenting as refractory intraoperative and postoperative wheezing.
A 29-year-old woman presented with severe refractory intraoperative wheezing and airflow limitation that resolved spontaneously. Contrast-enhanced computed tomographic (CT) scan of the thorax confirmed a right-sided aortic arch. Variable intrathoracic large airway obstruction that worsened markedly when the patient was in a supine position and slightly more following intravascular volume expansion was shown on flow-volume studies. We postulate the right-sided aortic arch caused airflow obstruction that worsened intraoperatively because of position and intravenous fluids.
Bose
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S
University Hospital, Department of Medicine, Saskatoon, Saskatchewan, Canada.
Hurst
T S
TS
Cockcroft
D W
DW
D000328:Adult; D000402:Airway Obstruction / Q000209:etiology*; D001013:Aorta, Thoracic / Q000002:abnormalities*; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D011187:Posture; D012135:Respiratory Sounds / Q000209:etiology*; D013514:Surgical Procedures, Operative; D014135:Tracheal Stenosis / Q000209:etiology