Study on infants bronchiostenosis compressed by secondary pulmonary arterial dilation and left-atrial enlargement

JIN Dan-qun; CHEN Yu-qing; XU Wei-hua; YANG Ze-yu; HU Ke-fei

Abstract：Objective To summarize the fiberoptic bronchoscopie findings, radiographic presentations and post-operative prognosis in infants bronchiostenosis compressed by secondary pulmonary arterial dilation and left-atrial enlargement in order to know more about compressed bronchiostenosis. Methods Totally 21 infants with significantly enlarged left atria and / or pulmonary arterial dilations undergoing surgery were observed in pediatric intensive care unit(PICU ) from Jan.2004 to Sep.2008. The clinical manifestations, bronchoscopie findings, radiographic presentations, operative effects and post-operative follow-up were recorded and analyzed. Results Echocardiography showed 19 cases of ventricular septaldefect(VSD) and / or patent ductus arteriosus(PDA), with 2 complete atrioventricular canal(CAVC). Fiberoptic bronchoscopy showed 16 cases of extrinsic compression of the left main bronchus, 3 left upper bronchium and 2 right middle bronchium, of which 9 cases had severe stenosis, 12 light to moderate stenosis. Coronary CT examinations showed the same results as bronchoscopy. Surgical operations were performed in all of the cases. Nine cases needed mechanical ventilation for up to 12 to 28 days with repeated extubatidn failures, 2 deaths. Nineteen cases were followed up from 3 months to 3 years, 2 deaths, while the others were in good condition. Conclusion The congenital heart disease (CHD) with secondary pulmonary arterial dilation and left-atrial enlargement can induce extrinsic compressed bronchiostenosis. Bronchoscopy and cornorary CT examinations have great significance in the diagnosis. Being fully aware of the anatomical abnormalities is of much help for the treatment program of CHD.