title: 3D-modelling of transient left bronchial obstruction following bidirectional superior cavopulmonary shunt.
abstract: Extrinsic compression of airways is one the most important causes of respiratory insufficiency in the perioperative period in children with congenital heart disease. This is especially true of pathologies that involve surgery of the aortic arch or conduit replacement of the right ventricular outflow tract. However bronchial obstruction is uncommon in the setting of bidirectional cavopulmonary shunt alone. We report the case of an infant with a functionally univentricular heart who had a bidirectional superior cavopulmonary shunt and disconnection of the main pulmonary artery from the ventricular mass with oversewing of pulmonary valve. Post-operatively the patient desaturated due to compression of left main bronchus by the left pulmonary artery anteriorly and the descending aorta posteriorly. This was clearly defined by CT based on 3D-modelling of the airways and great vessels. The child was managed conservatively by ventilator support, selective bronchial suctioning and systemic steroids with a successful outcome.
authors.affiliation: Department of Cardiothoracic Surgery, Section of Pediatric Cardiac Surgery, Hamad Hospital, Doha, Qatar, Doha, Qatar.
authors.forename: Reyaz A
authors.initials: RA
authors.lastname: Lone
authors.affiliation: Qatar Cardiovascular Research Centre.
authors.forename: Julien
authors.initials: J
authors.lastname: Chapron
authors.affiliation: Department of Cardiothoracic Surgery, Section of Pediatric Cardiac Surgery, Hamad Hospital, Doha, Qatar, Doha, Qatar.
authors.forename: Aslam
authors.initials: A
authors.lastname: Faris
authors.affiliation: Department of Cardiothoracic Surgery, Section of Pediatric Cardiac Surgery, Hamad Hospital, Doha, Qatar, Doha, Qatar.
authors.forename: Jiju
authors.initials: J
authors.lastname: John
authors.affiliation: Department of Radiology, Hamad Hospital, Doha, Qatar, Doha, Qatar.
authors.forename: Sandra Abou
authors.initials: SA
authors.lastname: Samaan
authors.affiliation: Department of Cardiothoracic Surgery, Section of Pediatric Cardiac Surgery, Hamad Hospital, Doha, Qatar, Doha, Qatar.
authors.forename: Akhlaque Nabi
authors.initials: AN
authors.lastname: Bhat
keywords: 3D-modelling; CT angiography; bronchial compression; descending aorta; left pulmonary artery