Short-length ligamentum arteriosum as a cause of congenital narrowing of the left main stem bronchus

Sacco, Oliviero; Santoro, Francesco; Ribera, Elena; Magnano, Gian Michele; Rossi, Giovanni

doi:10.1002/ppul.23460

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…Sacco and his colleagues (5) reported 4 girls who were evaluated for recurrent / chronic respiratory symptoms and found that a pulsatile extrinsic compression on the posterior bronchial wall of the left main stem, pressed between the descending aorta posteriorly and the left pulmonary artery anteriorly. The two arteries were closely linked together by a short length ligamentum that was resected with posterior aortopexy.…”

Section: Discussionmentioning

confidence: 99%

High Tracheal Bifurcation as a Cause of Left Main Bronchus Obstruction in Infant: A case report from Saudi Arabia

Khalid

Wadha

2018

The Egyptian Journal of Hospital Medicine

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Background: Congenital short trachea (CST) an uncommon abnormality is defined as a reduction in the number of tracheal rings to 15 or less, compared to the average of 17 rings in normal infants. As a result, the carina is situated at a higher level than usual that lead the left main bronchus to course abnormally behind the arch of the aorta, making it prone to compression. CST is associated with a number of syndromes, including the Di George syndrome, several types of congenital heart disease, some skeletal dysplasias and meningomyelocoele. Case study: We report a case of one Saudi infant who presented with respiratory distress since birth and hyperinflation of left side of the lung secondary to extrinsic narrowing of proximal left main stem bronchus due to compression by arch of the aorta, and he underwent successful aortopexy of the aortic arch for this condition.

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Section: Discussionmentioning

confidence: 99%

High Tracheal Bifurcation as a Cause of Left Main Bronchus Obstruction in Infant: A case report from Saudi Arabia

Khalid

Wadha

2018

The Egyptian Journal of Hospital Medicine

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“…Multidetector CT was performed with a 64‐slice CT scanner (Siemens Somatom Sensation 64, Siemens, Erlangen, Germany) 10 . An intravenous radiocontrast agent (Iomeron 300, Bracco, Milan, Italy) was administered in all patients, with a power injector via a peripheral vein.…”

Section: Methodsmentioning

confidence: 99%

“…Multidetector CT was performed with a 64-slice CT scanner (Siemens Somatom Sensation 64, Siemens, Erlangen, Germany). 10 An intravenous radiocontrast agent (Iomeron 300, Bracco, Milan, Italy) was administered in all patients, with a power injector via a peripheral vein. The examination was performed with breath holding at suspended inspiration but, in younger and noncooperative patients, quiet breathing was tolerated.…”

Section: Computed Tomography (Ct)mentioning

confidence: 99%

Is secondary tracheomalacia associated with airway inflammation and infection?

Capizzi

Salvati

Gallizia

et al. 2022

Pediatrics International

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Background Recurrent lower respiratory tract infections are among the most prevalent symptoms in secondary tracheomalacia due to mediastinal vascular anomalies (MVAs). It is not known whether this condition could result in persistent lower respiratory tract inflammation and subclinical infection. Methods A retrospective study was performed on records of children with tracheomalacia due to MVAs and recurrent respiratory infections who underwent computed tomography scan, bronchoscopy, and bronchoalveolar lavage (BAL) as part of their clinical evaluation. Results Thirty‐one children were included in the study: 21 with aberrant innominate artery, four with right aortic arch, one with double aortic arch, and five with aberrant innominate artery associated with right aortic arch. Cytological evaluation of bronchoalveolar lavage fluid showed increased neutrophil percentages and normal lymphocyte and eosinophil proportions. Microorganism growth was detected in 13 BAL samples, with a bacterial load ≥104 colony‐forming units/mL in eight (25.8%) of them. Most isolates were positive for Haemophilus influenzae. Bronchiectasis was detected in four children, all with BAL culture positive for H. influenzae. Four patients underwent MVA surgical correction and 27 conservative management, i.e., respiratory physiotherapy in all and high‐dose amoxicillin/clavulanic acid (40 mg/kg/day) for 2–4 weeks in those with significant bacterial growth. There was an excellent outcome in most of them. Conclusions Neutrophilic alveolitis is detectable in secondary tracheomalacia but is associated with a clinically significant bacterial load only in a quarter of the patients. Caution should be used regarding inappropriate antibiotic prescriptions to avoid the emergence of resistance, whilst airway clearance maneuvers and infection preventive measures should be promoted.

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“…Multidetector CT was performed with a 64-slice CT scanner (Siemens Somatom Sensation 64, Siemens, Erlangen, Germany) [11]. The intravenous contrast agent (Iomeron 300, Bracco, Milan, Italy) was administered, in all patients, with a power injector via a peripheral vein, and when possible, the examination was performed with breath holding at suspended inspiration, but in younger and noncooperative patients, quiet breathing was tolerated.…”

Section: Computed Tomography (Ct)mentioning

confidence: 99%

Is secondary tracheomalacia associated with persistent lower respiratory tract inflammation and subclinical infection?

Capizzi¹,

Silvestri²,

Rossi³

et al. 2020

Preprint

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Background. In secondary tracheomalacia due to mediastinal vascular anomalies one of the most prevalent symptom is recurrent lower respiratory tract (LRT) infections, related to defective airway clearance. Whether this condition could result in persistent LRT inflammation and subclinical infection is not known. Patients and methods. Children with tracheomalacia due to mediastinal vascular anomalies, recurrent (>3/y) LRT infections were evaluated while in stable condition. Computed tomography (CT) scan and bronchoscopy with bronchoalveolar lavage (BAL) were performed. Results. 31 children were included in the study: 21 with aberrant innominate artery (AIA), 4 with right aortic arch (RAA) and 1 with double aortic arch (DAA) and 5 with AIA associated with RAA. Cytological evaluation of BAL fluid showed increased neutrophil percentages and normal lymphocyte and eosinophil proportions. Microorganism growth was detected in 35.5% of BAL samples, with a bacterial load >105 colony-forming-units (CFU)/mL only in 10,2% of them. Most isolates were positive for Haemophilus influenzae, followed by Streptococcus pneumoniae, Group A β-hemolytic streptococci and Moraxella catarrhalis. Chest CT scan demonstrated the presence of bronchiectasis in 13% of the children, of which only one had a positive BAL culture for Haemophilus influenzae. Conclusions. Only in a small subgroup of children, persistent neutrophilic alveolitis was associated with a significant bacterial load and the presence of bronchiectasis. Because most pathogens detected in BAL samples cultures can produce biofilms, caution should be used in inappropriate antibiotic prescription in these patients that, chiefly in those with bronchiectasis, in which chest physiotherapy can be of great benefit.

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Short-length ligamentum arteriosum as a cause of congenital narrowing of the left main stem bronchus

Cited by 5 publications

References 24 publications

High Tracheal Bifurcation as a Cause of Left Main Bronchus Obstruction in Infant: A case report from Saudi Arabia

High Tracheal Bifurcation as a Cause of Left Main Bronchus Obstruction in Infant: A case report from Saudi Arabia

Is secondary tracheomalacia associated with airway inflammation and infection?

Is secondary tracheomalacia associated with persistent lower respiratory tract inflammation and subclinical infection?

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