Translocation of dilated pulmonary artery for relief of bronchial compression associated with ventricular septal defect

Abstract

Bronchial compression due to a dilated pulmonary artery is a troublesome problem in the surgical management of infants or children with congenital heart disease. We experienced an infantile case of ventricular septal defect and prolonged respiratory insufficiency caused by right bronchial compression and left pulmonary hypoplasia. Anterior translocation of the dilated right pulmonary artery and intracardiac repair succeeded in relieving the bronchial compression and improving left pulmonary function. We advocate that this procedure is useful for bronchial compression with congenital heart disease and maldevelopment of the lung.

Translational value of partial resection of the pulmonary artery wall for congenital heart disease-induced bronchial compression

“…Therefore, the right pulmonary artery is placed in the forward position or the pulmonary artery wall is folded to relieve this compression. 10 In the present investigation, the trachea or its affiliated structures that are adjacent to the heart, namely the descending aorta and the pulmonary artery, were compressed in patients with high pressure in the pulmonary artery, an increased pulmonary artery diameter, and an enlarged heart. These structures appear to “hold” the trachea, which may lead to tracheal compression.…”

Airway Improvement with Medium-Term Compression Duration after Right Pulmonary Artery Anterior Translocation

“…Airway compression from congenital heart disease is a major cause of respiratory issues. In such cases, airway relief by aortopexy, RPA anterior translocation, or sliding tracheoplasty concomitant with intracardiac repair has been successful for relieving airway compression [ 1 – 4 ]. Aortopexy is a surgical method that yields positive results in cases of severe, localized tracheobronchomalacia by pulling the aorta with minimal tissue dissection around the aorta [ 2 , 5 ].…”

Use of rotational angiography in assessing relationship of the airway to vasculature during cardiac catheterization

“…A factor contributing to the high prevalence may be due to the shorter trachea seen in these children with characteristic dysmorphic facial features . Associated congenital anomalies can also cause extrinsic airway compression, including vascular rings, dilated pulmonary arteries with or without left atrial enlargement, anomalous aortic or pulmonary arterial course, and dilated aorta . CHD patients undergo multiple surgical and catheterization procedures throughout their lifetime, with each procedure adding to their overall risk of morbidity and mortality.…”

“…Intervention, such as balloon arterioplasty with stent placement, may further compromise airway integrity and lead to worsening compression. Surgical intervention and post‐operative recovery may be further complicated by airway compromise . In addition, through the growth of the child with CHD after surgery and the development of scar tissue the proximity of intrathoracic structures in relationship to one another often change.…”