Bridging Bronchus – An Unsuspected Airway Anomaly Associated with Congenital Heart Disease: A Case Report with Review of Literature

Abstract

Abstract Background: The association of airway anomalies with congenital heart disease (CHD) is common, but often remains undetected, due to a lack of awareness. We describe the unfortunate demise of an infant with CHD due to delayed diagnosis of a bridging bronchus (BB) with multifocal bronchial stenosis. Clinical Description: An 18-month-old boy, who was a known case of ventricular septal defect (VSD), was hospitalized for the third time with symptoms of pneumonia and congestive heart failure. He also had intermittent stridor and wheeze similar to his earlier illnesses. Management and Outcome: After stabilization with bubble continuous positive airway pressure, antibiotics, and diuretics, he underwent surgery for the VSD and got extubated successfully on day 3. Subsequently, however, he failed to get weaned off further from respiratory support and started having recurrent episodes of stridor along with suprasternal retractions and wheeze. Computerized tomography (CT) showed BB with multifocal stenosis of the airway and sequestration of the left lower lobe of the lung. He developed pneumonia and succumbed to the illness before he could be considered for surgical correction of the airway anomalies. Conclusion: Awareness about associated airway anomalies and their preoperative detection may alter prognostication, parental counseling, surgical approach, and final outcome.