Abstract
The use of cardiopulmonary bypass as an adjunct to airway surgery for non-malignant diseases in adults is not well established in the UK. We are reporting two cases which demonstrate the additional benefits of using cardiopulmonary bypass during difficult bronchoscopy and complex airway stenting. The first case presents an emergency indication for cardiopulmonary bypass in a life-threatening but benign condition. The second case presented, utilises cardiopulmonary bypass standby as adjunct to a potentially life threatening procedure. A review of the literature is also provided.
Highlights
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
In the cases presented here, we found that CPB is safe and useful as a standby during complex stenting procedures for benign tracheo-bronchial conditions with better long term prognosis
The use of cardiopulmonary bypass to aid surgery for tracheal procedures is more frequently reported in infants and children than in adult population
Summary
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. 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 UltraflexTM 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. Her preoperative electrocardiogram and her routine bloods including full blood count, urea and electrolytes, creatinin, cardiac enzymes, liver function tests and coagulation profile were within the normal range She underwent elective bronchoscopy and stenting with Ultraflex, to the left main bronchus with CPB on standby. The bronchoscopic procedure was without complications and CPB was not required (Figure 2)
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