[Endostenting using a Y-stent for hematoma after thoracic aorta surgery].
OBJECTIVE
To describe the diagnostic and therapeutic management of extrinsic tracheobronchial compression after thoracic aorta surgery.


METHODS
We report the case of a female patient with Marfan syndrome.


RESULTS
A 27-year-old woman with Marfan syndrome presented respiratory distress after type III dissecting aneurysm of the descending aorta from extrinsic compression (hematoma) of the lower third of the trachea and the left bronchial stump. We placed a Y-stent (Y-Tracheobronxane, Novatech SA, France), thus restoring a satisfactory channel. A few days later, the patient developed right congestive heart failure from compression of the left pulmonary artery secondary to the progression of the hematoma. Medical treatment for this cardiological complication and the progressive resorption of the hematoma made it possible to remove the stent after 21 days with no dyspneic recurrence.


CONCLUSIONS
Placing a Y-stent is possible and effective and has few iatrogenic consequences in cases of extrinsic tracheobronchial compression from a hematoma occurring during heavy thoracic vascular surgery. With surgical revision impossible given the risks, stent placement allows progressive resorption of the hematoma, thus ending the compression of the bronchial tree.
Elgandli
D
D
Département d'ORL et de CCF, université Claude-Bernard-Lyon-1, CHU de La-Croix-Rousse, 103, grande rue de La-Croix-Rousse, 69004 Lyon, France.
Perottino
F
F
Bouchene
M
M
Poupart
M
M
Pignat
J-C
JC
Merrot
O
O
D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006406:Hematoma / Q000150:complications / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008382:Marfan Syndrome / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012131:Respiratory Insufficiency / Q000209:etiology; D015607:Stents; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures