title: Flexible fiberoptic bronchoscopy in children with heart diseases: a twelve years experience.
abstract: In children, cardiac diseases and respiratory disorders are tightly linked entities whose evaluation should be performed integrally. Flexible fiberoptic bronchoscopy (FB) presents a diagnostic and therapeutic role by assessing the airway anatomically, dynamically, and through the performance of several procedures. The present study describes our experience on FB assessment in children with congenital and acquired cardiac diseases, providing a characterization of the principal demographic and clinical features. Records of 72 patients under 14 years (mean age 21 months) with heart diseases, corresponding to 104 FB performed between January 1993 and October 2004 were reviewed. The principal cardiac diseases were left-to-right shunt (51.9%), followed by right-to-left shunt (17.3%) and miscellaneous cardiopathies (8.7%). The main indications for FB assessment were study of atelectasis (35%), stridor (14%), and pneumonia (14%). Airway malacias, as a group, were the commonest finding, represented mainly by left main bronchus malacia (24%). The second most common finding was stenosis by extrinsic compression, and among these, 75% corresponded to left main bronchus compression. Sixteen different types of clinically meaningful utilities were obtained. No mortality was reported and in only one procedure was there a major complication, which was easily managed. We concluded that FB is an important and safe diagnostic-therapeutic tool in the health care of neonates, infants, and children with a variety of cardiac diseases.
authors.affiliation: Department of Pediatrics, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Jaime
authors.initials: J
authors.lastname: Cerda
authors.forename: Jorge
authors.initials: J
authors.lastname: Chacón
authors.forename: Cristina
authors.initials: C
authors.lastname: Reichhard
authors.forename: Pablo
authors.initials: P
authors.lastname: Bertrand
authors.forename: Nils L
authors.initials: NL
authors.lastname: Holmgren
authors.forename: Cristián
authors.initials: C
authors.lastname: Clavería
authors.forename: Ignacio
authors.initials: I
authors.lastname: Sánchez
mesh_terms: D000293:Adolescent; D001982:Bronchial Diseases / Q000175:diagnosis; D018893:Bronchoalveolar Lavage; D001999:Bronchoscopy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000175:diagnosis; D005260:Female; D005336:Fiber Optic Technology; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D001261:Pulmonary Atelectasis / Q000209:etiology; D012135:Respiratory Sounds / Q000209:etiology; D014133:Tracheal Diseases / Q000175:diagnosis