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10.5606/tgkdc.dergisi.2014.7800
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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