title: Airway management and transesophageal echocardiographic monitoring for pulmonary artery sling.
abstract: Pulmonary artery sling is an uncommon vascular anomaly and can be life threatening when it causes tracheal compression. We report on a 14-day-old boy who presented with respiratory distress soon after birth. A series of examinations showed tracheal stenosis due to a pulmonary artery sling. Surgery was performed with the aid of cardiopulmonary bypass. The external compression and intrisic stenosis could not be resolved by vascular surgery because of tracheal malacia and a complete tracheal ring. We recommend cutting extra holes 1 to 2 cm from the distal end of the endotracheal tube for endobronchial intubation. The airway obstruction was resolved successfully with a custom-made endobronchial tube. However, the patient died of pneumomediastinum and pneumothorax induced by barotrauma, on the fourth postoperative day.
authors.affiliation: Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: C R
authors.initials: CR
authors.lastname: Lin
authors.forename: S K
authors.initials: SK
authors.lastname: Tsai
authors.forename: M J
authors.initials: MJ
authors.lastname: Wang
authors.forename: I S
authors.initials: IS
authors.lastname: Chiu
authors.forename: S J
authors.initials: SJ
authors.lastname: Chen
mesh_terms: D001980:Bronchi; D017548:Echocardiography, Transesophageal; D006801:Humans; D007231:Infant, Newborn; D007442:Intubation, Intratracheal; D008297:Male; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014132:Trachea / Q000000981:diagnostic imaging; D014135:Tracheal Stenosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*