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Ann Thorac Surg 2004;77:1420-1422
© 2004 The Society of Thoracic Surgeons

Case report

Stenting of the mainstem bronchus in children: a word of caution

Winfield J. Wells, MDa*, Namath S. Hussain, BSa, John C. Wood, MDa

a Divisions of Cardiothoracic Surgery and Pediatric Cardiology, Keck School of Medicine, University of Southern California and Childrens Hospital Los Angeles, Los Angeles, California, USA

Accepted for publication May 14, 2003.

* Address reprint requests to Dr Wells, Division of Cardiothoracic Surgery, Childrens Hospital Los Angeles, 4650 Sunset Blvd, MS 66, Los Angeles, CA 90027, USA.

We present two patients with critical hemorrhage following expandable metallic stenting of the left mainstem bronchus in children. Stent migration with erosion into a bronchial artery leading to mycotic pseudoaneurysm formation and overwhelming pulmonary hemorrhage occurred in both patients. One patient died from uncontrollable hemoptysis. The second patient was salvaged by left pneumonectomy and patch repair at the site of mycotic aortic rupture. Stenting of a mainstem bronchus, particularly in cyanotic children must be approached with extreme caution.




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