Tracheal compression caused by aneurysms of the aortic arch. Implications for the anaesthetist

Two cases of severe tracheal compression caused by aortic arch aneurysm are reported. There was a marked similarity in the clinical presentation of these patients but the different outcomes of surgical resection appeared to be related to the content of the aneurysms. The first patient had a fixed obstruction due to solid clot, which proved irreversible; while the second had an aneurysm containing fluid blood. The anaesthetic management of this complication is discussed.