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

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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.

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Authors and Affiliations

  1. Department of Anesthesiology, Kinki University School of Medicine, 377-2 Ohno-higashi, Osaka-sayama, 589-8511, Japan

    Tatsushige Iwamoto, Yoshihiro Takasugi, Kenji Hiramatsu & Yoshihisa Koga

  2. Department of Radiology, Kinki University School of Medicine, Osaka, Japan

    Kensuke Kozuka & Takamichi Murakami

  3. Department of Radiology, Kinki University Hospital, Osaka, Japan

    Tatsuo Konishi

Authors
  1. Tatsushige Iwamoto
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  2. Yoshihiro Takasugi
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  3. Kenji Hiramatsu
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  4. Yoshihisa Koga
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  5. Tatsuo Konishi
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  6. Kensuke Kozuka
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  7. Takamichi Murakami
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Iwamoto, T., Takasugi, Y., Hiramatsu, K. et al. Three-dimensional CT image analysis of a tracheal bronchus in a patient undergoing cardiac surgery with one-lung ventilation. J Anesth 23, 260–265 (2009). https://doi.org/10.1007/s00540-008-0716-1

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  • DOI: https://doi.org/10.1007/s00540-008-0716-1

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