Abstract
Objective: To demonstrate tracheobronchial compression caused by tortuous and dilated large and medium-sized thoracic arteries and the characteristics of these arteries by noninvasive imaging modalities. Patients and Methods: Imaging and clinical data of six patients with tortuous, dilated large and medium-sized thoracic arteries (July 2007 to December 2013) were reviewed. The imaging data were mainly acquired by cardiac multi-slice computed tomography (MSCT) or/and cardiac magnetic resonance imaging (MRI). The number and location of tracheobronchial stenosis were noted, and the severity of stenosis was categorized. The characteristics of large and medium-sized thoracic arteries were also noted. Further, the correlation between the severity of tracheobronchial stenosis and tortuous, dilated large and medium-sized thoracic arteries was analyzed. One patient who was suspected to have arterial tortuosity syndrome underwent genetic analysis. Results: All six patients demonstrated varying degrees of tortuosity and dilation of large and medium-sized thoracic arteries. Five were noted to have varying degrees of tracheobronchial compression and respiratory symptoms. Two have varying degrees of connective tissue abnormalities. Conclusion: Tracheobronchial compression of tortuosity and dilation of large and medium-sized thoracic vascular origin is an uncommon and frequently unrecognized cause of respiratory distress in children. Noninvasive imaging modalities like MSCT and MRI could clearly demonstrate tracheobronchial compression and vascular abnormalities simultaneously. Attention should be given to tracheobronchial compression when disease management decisions are made, especially for determining surgical strategies and for those patients who are 6-9 months old.B. MAB is frequent in patients with COPD and is associated with hypoxemia independent of other cardiovascular risk factors.
Highlights
Cardiovascular structures and airway anatomy are closely related; tracheobronchial compression often occurs in some cardiovascular abnormalities, such as vascular rings, left pulmonary artery sling, and absent pulmonary valve, and could lead to recurrent respiratory infection, shortness of breath and wheezing [1,2,3,4]
It is founded that tracheobronchial compression can be caused by certain rare vascular anomalies, such as tortuosity, dilation and aneurysm formation in large and medium-sized thoracic arteries, which are found in some rare connective tissue disorders such as arterial tortuosity syndrome (ATS), Loeys-Dietz syndrome (LDS) and Marfan syndrome (MFS) [511]
Noninvasive imaging modalities such as multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) with some special techniques can clearly demonstrate the anatomic features of arterial abnormalities and tracheobronchial compression, and the findings of airway should be considered when making decisions about disease management
Summary
Cardiovascular structures and airway anatomy are closely related; tracheobronchial compression often occurs in some cardiovascular abnormalities, such as vascular rings, left pulmonary artery sling, and absent pulmonary valve, and could lead to recurrent respiratory infection, shortness of breath and wheezing [1,2,3,4]. It is founded that tracheobronchial compression can be caused by certain rare vascular anomalies, such as tortuosity, dilation and aneurysm formation in large and medium-sized thoracic arteries, which are found in some rare connective tissue disorders such as arterial tortuosity syndrome (ATS), Loeys-Dietz syndrome (LDS) and Marfan syndrome (MFS) [511]. These disorders are frequently unfound or unrecognized in children especially when the patient was asymptomatic.
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