The Journal of Thoracic and Cardiovascular Surgery, Vol 77, 212-216, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Pneumonectomy for intractable left bronchial compression in d- transposition of the great arteries
CC Lenox, RG Pontius, JR Zuberbuhler, WH Neches, SC Park, RA Mathews and FJ Fricker
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.
