Successful ventilator weaning following vascular bypass in patient with vascular tracheobronchial compression

A 74-year-old man, who had undergone thoracoplasty for tuberculous sequelae 54 years earlier, was referred to our hospital with a chief complaint of dyspnea. He had recently received mechanical ventilation due to pneumonia. However, although the pneumonia had improved, extubation was prevented by the presence of hypercapnic respiratory failure with tracheal stenosis due to compression of the right aortic arch and the left common carotid artery. Bypass surgery was performed, during which the left subclavian artery was placed over the left common carotid artery. Surgery resulted in expansion of the cross-sectional tracheal stenosis area from 11.60 mm² to 62.62 mm², and the patient was successfully weaned off ventilatory support.