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Cardiovascular-associated tracheobronchial obstruction in children

Published online by Cambridge University Press:  24 May 2012

Shen-Hao Lai ,
Sui-Ling Liao  and
Kin-Sun Wong
Shen-Hao Lai
Affiliation:
Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan
Sui-Ling Liao
Affiliation:
Keelung, Taiwan
Kin-Sun Wong*
Affiliation:
Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan
*
Correspondence to: Dr K.-S. Wong, MD, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan County 33305, Taiwan. Tel: 886 3 3281200 ext. 8202; Fax: 886 3 3288957; E-mail: [email protected]
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Abstract

Tracheobronchial compression of cardiovascular origin is an uncommon and frequently unrecognised cause of respiratory distress in children. The compression may be due to encircling vessels or dilated neighbouring cardiovascular structures. Bronchoscopy and detailed radiography, especially computed tomography and magnetic resonance imaging, are among the most powerful diagnostic tools. Few previous reports have addressed the relationship between bronchoscopic findings and underlying cardiovascular anomalies. The objective of this study was to correlate bronchoscopic and radiographic findings in children with cardiovascular-associated airway obstruction. A total of 41 patients were recruited for the study. Patients with airway obstruction were stratified on the basis of the aetiology of the cardiovascular structures and haemodynamics into an anatomy-associated group and a haemodynamics-associated group. In the anatomy-associated group, stenosis and malacia were found with comparable frequency on bronchoscopy, and the airway obstructions were mostly found in the trachea (71% of patients). In the haemodynamics-associated group, malacia was the most common bronchoscopic finding (85% of patients), and nearly all locations of airway involvement were in the airway below the carina (90% of patients). The tracheal compression was usually caused by aberrant systemic branching arteries in the anatomy-associated group. In the haemodynamics-associated group, the causal relationships varied. Tracheal compression was often caused by lesions of the main pulmonary artery and aorta, whereas obstruction of the right main bronchus was caused by lesions of the main pulmonary artery and right pulmonary artery. The causes of left main bronchus compression were more diverse. In summary, the bronchoscopic presentations and locations are quite different between these two groups.

Keywords

Airway obstructionbronchoscopycardiovascular
Type
Original Article
Information
Cardiology in the Young , Volume 23 , Issue 2 , April 2013 , pp. 233 - 238
Copyright
Copyright © Cambridge University Press 2012 

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