Management of extensive lesions of the lower trachea using emergency cardiopulmonary bypass

Rapid cardiopulmonary deterioration in patients with extensive lesions of the lower trachea presents a serious challenge in the emergency care. Conventional methods may prove inadequate to achieve airway control and to stablilize the critical condition. Severe airway obstruction and/or massive air leakage are the main causes of failure. An aggressive operative approach is mandatory. Institution of emergency cardiopulmonary bypass for resuscitative purposes and definitive surgical repair of those life-threatening uncommon tracheal lesions seems essential to us. Two cases, managed according to this concept, are presented.