Tracheal Compression Caused by a Mediastinal Hematoma After Interrupted Aortic Arch Surgery

Abstract

SummaryCongenital abnormalities of the aortic arch include interrupted aortic arch (IAA), coarctation of the aorta (CoA), and double aortic arch (DAA). Aortic arch repair is difficult and postoperative complications are common. However, postoperative tracheobronchial stenosis with respiratory insufficiency is an uncommon complication and is usually caused by increased aortic anastomotic tension. We report here a case of tracheal compression by a mediastinal hematoma following IAA surgery. The patient underwent a repeat operation to remove the hematoma and was successfully weaned off the ventilator.In cases of tracheobronchial stenosis after aortic arch surgery, airway compression by increased aortic anastomotic tension is usually the first diagnosis considered by clinicians. Other causes, such as mediastinal hematomas, are often ignored. However, the severity of symptoms with mediastinal hematomas makes this an important entity. (Int Heart J 2017; 58: 629-632)

A New <i>ISL1</i> Loss-of-Function Mutation Predisposes to Congenital Double Outlet Right Ventricle

“…2) Based on final anatomic and physiological phenotypes, CHDs have been classified into at least 25 distinctive types, such as ventricular septal defect (VSD), double-orifice mitral valve, atrial septal defect, coronary artery anomaly, patent ductus arteriosus, Ebstein's anomaly, tetralogy of Fallot, double outlet right ventricle (DORV), aortic stenosis, transposition of the great arteries, truncus arteriosus, interrupted aortic arch, coarctation of the aorta, pulmonary stenosis, endocardial cushion defect, hypoplastic left ventricle, and anomalous pulmonary venous connection. 1,[2][3][4][5][6][7][8] Although minor CHDs may resolve spontaneously, 2) severe CHDs require timely intervention in the first year of life and otherwise may give rise to reduced exercise capacity and poor health-related quality of life, [9][10][11] neurodevelopmental anomaly or brain injury, [12][13][14] pulmonary arterial hypertension, [15][16][17][18][19] hemorrhagic or thromboembolic stroke, [20][21][22] dementia, 23) infective endocarditis, [18][19][20][21][22][23][24][25][26][27][28][29][30] myocardial infarction, 31,32) myocardial fibrosis, [33][34]…”