Successful management of left main bronchial stenosis as a rare complication of pericardiectomy

Abstract

We present a rare complication of pericardiectomy and the effective management thereof. A 67-year-old female with dyspnea and upper abdominal pain was received at our department upon referral. Chest roentgenogram and cardiac catheterization preceded a diagnosis of constrictive pericarditis. Pericardiectomy was performed subordinate to median sternotomy and left anterolateral thoracotomy. Extubation was carried out on day 2 but reintubation was necessitated on the same day as a result of progressive dyspnea. Chest roentgenogram revealed an atelectasis of the left lung. Fiberoptic bronchoscopy showed left main bronchial stenosis resulting from a pulsating external structure. A postoperative computed tomogram substantiated the stenotic left main bronchus between the dilated left pulmonary artery and the thoracic descending aorta. An expandable metallic stent for the treatment of this complication was selected over other invasive procedures. Two years of follow-up reveal no complications. Accordingly, an expandable metallic stent has demonstrated its effectiveness not only on bronchial stenosis due to malignancy or tuberculosis but on benign cases such as this as well.