Tracheal Compression Caused by a Mediastinal Hematoma After Interrupted Aortic Arch Surgery.

Congenital abnormalities of the aortic arch include interrupted aortic arch (IAA), coarctation of the aorta (CoA), and double aortic arch (DAA). Aortic arch repair is difficult and postoperative complications are common. However, postoperative tracheobronchial stenosis with respiratory insufficiency is an uncommon complication and is usually caused by increased aortic anastomotic tension. We report here a case of tracheal compression by a mediastinal hematoma following IAA surgery. The patient underwent a repeat operation to remove the hematoma and was successfully weaned off the ventilator.In cases of tracheobronchial stenosis after aortic arch surgery, airway compression by increased aortic anastomotic tension is usually the first diagnosis considered by clinicians. Other causes, such as mediastinal hematomas, are often ignored. However, the severity of symptoms with mediastinal hematomas makes this an important entity.

[1]  M. Turrentine,et al.  Follow-up of surgical correction of aortic arch anomalies causing tracheoesophageal compression: a 38-year single institution experience. , 2009, Journal of pediatric surgery.

[2]  M. Elliott,et al.  Aortopexy for persistent tracheal obstruction after double aortic arch repair. , 2009, Journal of pediatric surgery.

[3]  W. Williams,et al.  Management and Outcomes of Double Aortic Arch in 81 Patients , 2006, Pediatrics.

[4]  M. Ando,et al.  End-to-side anastomosis for coarctation of the aorta and type A aortic arch interruption with hypoplastic aortic arch. , 2006, The Japanese journal of thoracic and cardiovascular surgery : official publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai zasshi.

[5]  E. Tireli,et al.  Aortic Arch Reconstruction with Pulmonary Autograft Patch in Coarctation and Interruption of the Aorta , 2005, Journal of cardiac surgery.

[6]  J. Hess,et al.  Repair of interrupted aortic arch: results after more than 20 years. , 2000, The Annals of thoracic surgery.

[7]  T. Miyamoto,et al.  Fontan completion following flow adjustable bilateral pulmonary artery banding. , 2014, International heart journal.