Pneumonectomy for intractable left bronchial compression in d-transposition of the great arteries
Lenox, C.C.; Pontius, R.G.; Zuberbuhler, J.R.; Neches, W.H.; Park, S.C.; Mathews, R.A.; Fricker, F.J.
Journal of Thoracic and Cardiovascular Surgery 77(2): 212-216
1979
ISSN/ISBN: 0022-5223 PMID: 762961 Document Number: 144244
In infants with transposition of the great arteries (TGA) tracheobronchial obstruction may occur as a result of compression by a dilated posterior pulmonary artery, especially if there is a large interventricular septal defect with its attendant large pulmonary blood flow and high pressure. Banding of the pulmonary artery may give temporary relief. A patient with TGA had collapse of the left lung at 2 months of age, following atrial septectomy. Bronchoscopy and bronchography revealed extrinsic compression of the left main bronchus. Banding of the pulmonary artery at 6 months of age relieved the respiratory distress. At 8 years of age atelectasis of the left lung recurred following a Mustard procedure. Two additional procedures were attempted to decrease the pressure of the pulmonary artery on the bronchus but these were unsuccessful. At age 9 years, pneumonectomy, her sixth thoracotomy, was performed as a final attempt to relieve the respiratory problem caused by persistent atelectasis. She is now 17 years of age and has remained asymptomatic during the last 8 years.