ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Tracheal stent implantation with extracorporeal circulation
İsmail Aydın Erden, Banu Ayhan, Alev Şaylan, Seda Banu Akıncı, Bilge Çelebioğlu, Meral Kanbak, Ülkü Aypar
Hacettepe Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Ankara, Türkiye
DOI : 10.5606/tgkdc.dergisi.2014.7800
Oxygenation of the patients with tracheal stenosis under anesthesia can be provided by many traditional techniques such as intubation or tracheotomy, while extracorporeal circulation is an unusal method. A 73-year-old male patient in American Society of Anesthesiologists (ASA) score IVE was admitted to intensive care unit for respiratory distress and a nonresectable malignant external mass, from lower border of the cricoid cartilage up to 5 cm above the carina of 6 cm segment, surrounding vascular structures and trachea, leading to 1 mm diameter patency in the narrowest part, was present. Due to the location and structure of the lesion, safety of airway of the patient would not be provided by routine methods, hence, a stent was decided to be placed on stenotic segment of the trachea under oxygenation with extracorporeal circulation. Following appropriate preparation, patient was monitored in the operating room, and intravenous fentanyl and propofol infusion was started. Femoral artery and vein was cannulated under local anesthesia. After heparinization, oxygenation was achieved by extracorporeal circulation. Stents were placed using rigid bronchoscopy and fluoroscopy on tracheal lesion. After the procedure, the patient was intubated and extracorporeal circulation was terminated. The patient was monitored under sedation in the intensive care unit. He was extubated in next morning. Stent implantation, which requires a complete preoperative preparation for difficult airway, was successfully applied to our patient following a multidisciplinary approach. During the anesthesia of airway surgery, oxygenation with extracorporeal circulation application is a life-saving strategy.
Keywords : Airway obstruction; anesthesia; cardiopulmonary bypass; extracorporeal circulation; tracheal stenosis
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