Three-dimensional CT image analysis of a tracheal bronchus in a patient undergoing cardiac surgery with one-lung ventilation.
The incidence of a tracheal bronchus--that is, a congenitally abnormal bronchus originating from the trachea or main bronchi--is 0.1%-2%. Serious hypoxia and atelectasis can develop in such patients with intubation and one-lung ventilation. We experienced a remarkable decrease in peripheral oxygen saturation (SpO2) and a rise in airway pressure during placement of a double-lumen endobronchial tube in a patient with patent ductus arteriosus and tracheal bronchus. Substitution of the double-lumen tube with a bronchial blocker tube provided secure isolation of the lung intraoperatively. A type I tracheal bronchus and segmental tracheal stenosis were identified on postoperative three-dimensional (3D) computed tomographic (CT) images. Preoperative examination of chest X-rays, CT images, and preoperative tracheal 3D images should preempt such complications and assist in securing safe and optimal one-lung ventilation.
Iwamoto
Tatsushige
T
Department of Anesthesiology, Kinki University School of Medicine, 377-2 Ohno-higashi, Osaka-sayama, 589-8511, Japan.
Takasugi
Yoshihiro
Y
Hiramatsu
Kenji
K
Koga
Yoshihisa
Y
Konishi
Tatsuo
T
Kozuka
Kensuke
K
Murakami
Takamichi
T
D001980:Bronchi / Q000002:abnormalities*; D001995:Bronchography; D006348:Cardiac Surgical Procedures; D004374:Ductus Arteriosus, Patent / Q000601:surgery; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007442:Intubation, Intratracheal; D008875:Middle Aged; D013902:Radiography, Thoracic; D012121:Respiration, Artificial; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000002:abnormalities* / Q000000981:diagnostic imaging*