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Welded tracheal stent removal in a child under cardiopulmonary bypass
1Department of Anesthesiology, Taipei-Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
Insights
Critical airway obstruction during metallic tracheal stent removal in a child was successfully managed with cardiopulmonary bypass. This case highlights a rare complication and the importance of emergency interventions for pediatric airway management.
Area of Science:
- Pediatric Pulmonology
- Thoracic Surgery
- Medical Device Engineering
Background:
- Metallic tracheal stents are utilized for treating pediatric tracheomalacia.
- Stent removal can pose risks, particularly with welded designs.
Observation:
- A critical airway obstruction event occurred during the removal of a welded metallic tracheal stent.
- The procedure involved a rigid bronchoscope under general anesthesia.
Findings:
- Emergency cardiopulmonary bypass was initiated to stabilize the patient.
- Successful stent removal was achieved through direct tracheal opening.
Implications:
- This case underscores the potential for severe complications during tracheal stent removal.
- Highlights the necessity of advanced life support and surgical techniques for managing airway emergencies in pediatric patients.
- Emphasizes the need for careful consideration of stent design and removal protocols.
Abstract:
Metallic tracheal stents have been used in the treatment of paediatric tracheomalacia for more than a decade. We describe a case in which critical airway obstruction occurred during removal of a welded tracheal stent using a rigid bronchoscope under general anaesthesia. Life-saving cardiopulmonary bypass was instituted urgently, and the welded stent was then removed successfully by directly opening the trachea.