Application of fibrobronchoscopy-guided aortic suspension in pediatric patients with bronchial compression resulting from repair of coarctation of the aorta: a case report.

Abstract

Background: Coarctation of the aorta (CoA) is one of the more prevalent congenital heart diseases (CHD). The conventional treatment approach involves surgical correction of the coarctation. This procedure, however, can be associated with several complications, such as re-stenosis, aneurysm formation and pseudoaneurysm. One rare but significant complication is left bronchial compression, which may result from anterior displacement of the thoracic aorta or compression of the trachea by adherent tissue.

Case presentation: We present a case of a 7-month-old postoperative CoA patient who developed stenosis due to compression of the left main bronchus by the thoracic aorta. After comprehensive evaluation, we utilized a fiberoptic bronchoscope to accurately expose the site of aortic compression and subsequently performed bronchial release and aortic suspension procedures to alleviate the symptoms. The child demonstrated a satisfactory recovery following the surgical intervention. This successful case provides valuable insights for managing similar cases in the future.

Conclusions: Computing tomography (CT) airway reconstruction enables precise diagnosis of tracheal stenosis secondary to aortic arch pathology or coarctation repair. Intraoperative fiberoptic bronchoscopy provides real-time anatomical localization of stenotic segments, warranting standardization in high-risk aortic surgeries to ensure airway patency. Three-dimensional airway modeling should be incorporated into perioperative reassessment and longitudinal follow-up protocols.