%0 Journal Article
%T Interventional bronchoscopy for benign tracheobronchial diseases under cardiopulmonary bypass support: case reports and literature review
%A Hussamuddin Adwan
%A Christopher H Wigfield
%A Stephen Clark
%A Sion Barnard
%J Journal of Cardiothoracic Surgery
%D 2008
%I BioMed Central
%R 10.1186/1749-8090-3-27
%X Although the use of cardiopulmonary bypass (CPB) is well established for interventions to treat tracheal stenosis in children, its use during bronchoscopy or tracheal procedures has been less frequently reported in adults. Its use as a standby adjunct to bronchoscopy and tracheal stenting has rarely been reported in the UK.We would like to report an additional use for CPB for support during bronchoscopy and tracheal stenting for non-malignant diseases.A 56 year old man presented with progressively worsening dyspnoea at rest. There was no history of chronic lung disease or cyanosis. On examination, he was found to have bilateral chest rhonchi and absent nasal cartilages. Investigation showed reduced FEV1 to 0.8 litres (23% predicted), and within normal basic blood tests. His medications included Prednisolone, Salbutamol and Seretide inhalers, and he was taking Mucolyn syrup regularly. Clinical diagnosis at time of referral was Relapsing Polychondritis, which was further supported by the bronchoscopy findings and a CT scan showing tracheobronchial thickening [1,2]. He underwent endobronchial stenting with a self-expanding metal stent (The Ultraflex£¿ Tracheobronchial Stent System, Boston Scientific, MA, US) in December 2005 to the trachea and separately to the left main bronchus; post operatively he was well and was discharged after 2 days.On subsequent review his symptoms showed minimum improvement and his exercise tolerance was approximately 100 yards on the flat. Six months after his first bronchoscopy and stenting he had a silicon stent (The TRACHEOBRONXANE£¿ Dumon£¿ Silicone Stent, Novatech SA, France) inserted into the bronchus intermedius on the right side. During that procedure a subglottic stricture was noted and his airway was found to be very collapsible. Just prior to his planned discharge, he developed noticeable stridor and therefore the stent had to be removed urgently. He deteriorated to type 1 respiratory failure for which he was admitted to the Intensiv
%U http://www.cardiothoracicsurgery.org/content/3/1/27