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Journal of Anesthesia

, Volume 23, Issue 2, pp 260–265 | Cite as

Three-dimensional CT image analysis of a tracheal bronchus in a patient undergoing cardiac surgery with one-lung ventilation

  • Tatsushige Iwamoto
  • Yoshihiro Takasugi
  • Kenji Hiramatsu
  • Yoshihisa Koga
  • Tatsuo Konishi
  • Kensuke Kozuka
  • Takamichi Murakami
Clinical Report

Abstract

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 (\( Sp_{O_2 } \)) 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.

Key words

Tracheal bronchus Three-dimensional computed tomography One-lung ventilation Tracheal stenosis Congenital heart disease 

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Copyright information

© Japanese Society of Anesthesiologists 2009

Authors and Affiliations

  • Tatsushige Iwamoto
    • 1
  • Yoshihiro Takasugi
    • 1
  • Kenji Hiramatsu
    • 1
  • Yoshihisa Koga
    • 1
  • Tatsuo Konishi
    • 3
  • Kensuke Kozuka
    • 2
  • Takamichi Murakami
    • 2
  1. 1.Department of AnesthesiologyKinki University School of MedicineOsaka-sayamaJapan
  2. 2.Department of RadiologyKinki University School of MedicineOsakaJapan
  3. 3.Department of RadiologyKinki University HospitalOsakaJapan

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