Severe bronchospasm during cardiopulmonary bypass is infrequent. Since the first report in 1973, ~ only 22 additional cases have been reported, all involving adults, some with a previous history of airway hyper-reactivity. 2-~3 We report a case in a child with a known history of atopy and asthma, and present a review of this rare condition.Case report A six-year-old boy with recurrent sub-aortic stenosis and aortic valve insufficiency was scheduled for elective resection of a sub-aortic membrane and a pulmonary valve autograft to the aortic position (Ross procedure). His past surgical history was complex; division of a patent ductus arteriosus and repair of coarctation of the aorta had been performed in the neonatal period. A previous operation for subaortic stenosis had been performed at two years of age. The patient had also required numerous surgical procedures to correct anal and renal abnormalities. The proposed operation was necessary to correct a 40-50 mmHg gradient across the left ventricular outflow tract and 2+ aortic regurgitation. Cardiac catheterization data were otherwise normal, demonstrating good left ventricular function, a left ventricular end-diastolic pressure of < I 0 mmHg and no evidence of pulmonary hypertension. The patient was asymptomatic on the morning of his scheduled surgery and was not taking any medication. The past medical history included atopic dermatitis and eczema which was treated with cortisone cream, Radioallergoabsorbent testing (RAST) demonstrated high sensitivity to egg white, milk and wheat. The patient also had reactive airways disease which was periodically triggered by over-exertion or upper respira- CAN J ANAESTH 1996 / 43: 12 /pp 1244