Abstract
Objective: There is potentially airway obstruction in children with congenital heart disease, and it is associated with complications during perioperative management. The purpose of this study was to evaluate the frequency and severity of these phenomena in children with congenital heart disease and to appreciate the value of examination with a bronchoscopy and cineangiography.Methods: Ninety-eight children with congenital heart disease who showed airway obstruction were reviewed. Fiberoptic bronchoscopy and cineangiography were performed in case of clinical respiratory signs and systematically performed in case of preoperative assessment of a cardiopathy known to possibly provoke airway compression.Results: Between July 1991 and 2005, airway obstruction occurred in a total of 98 children (96 cases in National Cardiovasucular Center, Osaka, and 2 cases in The University of Tokyo Hospital, Tokyo) who had been operated for congenital heart disease. Except 13(13%) of children (11 with congenital tracheal stenosis, 1 with bronchomalacia, 1 with laryngomalacia), all other 85(87%) children showed airway obstruction by external compression. 13(13%) of children required surgical repair, and the others could be treated preservatively. In 8(8%) of children, airway compression was disappeared in itself after the operation. In 85 showed external airway compressions, 6 were tracheal compression, 59 were left main bronchial compression, 2 were both main bronchial compression, 13 were right main bronchus or right main intermediate truncus, 2 were right upper bronchus, and 3 were left upper or lower. Conclusion: Precise evaluations of the airway obstruction by both bronchoscopy and cineangiography are important for the management of congenital heart disease children who show symptoms of the airway obstruction. Perioperative airway obstruction and the requirement of surgical restoration of major vascular can be estimate from these evaluations.
