Download PDF
Thorac Cardiovasc Surg 2012; 60(04): 295-298
DOI: 10.1055/s-0030-1271014
Case Reports
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Perioperative Airway Management Strategy and Posttransplant Successful Tracheal Resection and Reconstruction in a Heart Transplant Candidate with Post-intubation Stenosis

M. U. Ergenoglu
1   Department of Cardiovascular Surgery, Yeditepe University Hospital, Istanbul, Turkey
,
S. Ercan
2   Department of Thoracic Surgery, Yeditepe University Hospital, Istanbul, Turkey
,
H. Yerebakan
1   Department of Cardiovascular Surgery, Yeditepe University Hospital, Istanbul, Turkey
,
E. Pektok
1   Department of Cardiovascular Surgery, Yeditepe University Hospital, Istanbul, Turkey
,
S. Kucukaksu
1   Department of Cardiovascular Surgery, Yeditepe University Hospital, Istanbul, Turkey
› Author Affiliations
Further Information

Publication History

06 January 2011
21 February 2011

01 March 2011

Publication Date:
21 April 2011 (online)

    Permissions and Reprints All articles of this category

Abstract

Post-intubation tracheal stenosis (PTS) is an important clinical situation. It is estimated to occur in approximately 5% to 20% of intubated or tracheostomized patients. PTS most commonly occurs after prolonged intubation, and the treatment options have been well discussed in the literature. However, in solid organ transplantation, the necessity of administering high doses of corticosteroids as well as immunosuppressive therapies may compromise the healing processes following tracheal resection and reconstruction, requiring different treatment strategies for simultaneous PTS. We present a patient suffering from end-stage heart failure and post-intubation tracheal stenosis along with our treatment strategy.

Key words

heart - trachea - post-intubation tracheal stenosis - heart transplantation
 

  • References

  • 1 Couraud L, Jougon JB, Velly JF. Surgical treatment of nontumoral stenoses of the upper airway. Ann Thorac Surg 1995; 60: 259-260
    PubMedGoogle Scholar
  • 2 Schmidt WA, Schaap RN, Mortensen JD. Immediate mucosal effects of short-term, soft-cuff, endotracheal intubation. A light and scanning electron microscopic study. Arch Pathol Lab Med 1979; 103 (10) 516-521
    PubMedGoogle Scholar
  • 3 Grillo HC. Surgical treatment of postintubation tracheal injuries. J Thorac Cardiovasc Surg 1979; 78: 860-875
    PubMedGoogle Scholar
  • 4 Grillo HC. Primary reconstruction of airway after resection of subglottic laryngeal and upper tracheal stenosis. Ann Thorac Surg 1982; 33 (1) 3-18
    CrossrefPubMedGoogle Scholar
  • 5 Fernando HC, Sherwood JT, Krimsky W. Endoscopic therapies and stents for benign airway disorders: where are we, and where are we heading?. Ann Thorac Surg 2010; 89: S2183-S2187
    CrossrefPubMedGoogle Scholar
  • 6 Cooper JD, Grillo HC. The evolution of tracheal injury due to ventilatory assistance through cuffed tubes: a pathologic study. Ann Surg 1969; 169: 334-348
    CrossrefPubMedGoogle Scholar
  • 7 Grillo HC, Donahue DM, Mathisen DJ, Wain JC, Wright CD. Postintubation tracheal stenosis. Treatment and results. J Thorac Cardiovasc Surg 1995; 109: 492-493
    PubMedGoogle Scholar
  • 8 Mathias DB, Wedley JR. The effects of cuffed endotracheal tubes on the tracheal wall. Br J Anaesth 1974; 46: 849-852
    CrossrefPubMedGoogle Scholar
  • 9 Spittle N, McCluskey A. Lesson of the week: tracheal stenosis after intubation. BMJ 2000; 321: 1000-1002
    CrossrefPubMedGoogle Scholar
  • 10 Wright CD, Grillo HC, Wain JC , et al. Anastomotic complications after tracheal resection: prognostic factors and management. J Thorac Cardiovasc Surg 2004; 128: 731-739
    CrossrefPubMedGoogle Scholar
  • 11 Velly JF, Roques X, Laborde N, Dubrez J, Baudet E, Couraud L. [Simultaneous tracheal resection-anastomosis and heart transplantation]. Ann Chir 1991; 45: 146-148
    PubMedGoogle Scholar
  • 12 Smith ME, Elstad M. Mitomycin C and the endoscopic treatment of laryngotracheal stenosis: are two applications better than one?. Laryngoscope 2009; 119: 272-283
    CrossrefPubMedGoogle Scholar