Log in

Institution of cardiopulmonary bypass in an awake patient for resection of isolated intrathoracic right subclavian artery aneurysm causing near total compression of the trachea

  • Case report
  • Published:
Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

The subclavian artery’s intrathoracic segment is a rare peripheral artery aneurysm site. Common causes are atherosclerosis, trauma, vasculitis, and infection. Subclavian artery aneurysms have a higher propensity for rupture, thrombosis, embolization, and compression of surrounding structures, thus necessitating urgent surgical care. Herein, we describe a case of isolated intrathoracic right subclavian artery aneurysm presenting with orthopnea and hoarseness due to near total tracheal compression and recurrent laryngeal nerve compression. We also describe in detail the necessary preparation for and use of pre-anesthesia cardiopulmonary bypass for surgical excision.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Lee KS, Jung Y, Jeong IS, Song SY, Na KJ, Oh SG. Open surgical treatment of subclavian artery pseudoaneurysm after endovascular repair: a case report. J Cardiothorac Surg. 2022;17:25.

  2. Ramtoola MT, Bhatti M, Shetty R. A case report of a ruptured subclavian artery aneurysm presenting to the emergency department. Clin Case Rep. 2019;7:797–800.

  3. Bittar D. Respiratory obstruction associated with induction of general anesthesia in a patient with mediastinal Hodgkin’s disease. Anesth Analg. 1975;54:399–403. https://doi.org/10.1213/00000539-197505000-00038.

  4. Erdös G, Tzanova I. Perioperative anaesthetic management of mediastinal mass in adults. Eur J Anaesthesiol. 2009;26:627–32. https://doi.org/10.1097/EJA.0b013e328324b7f8.

  5. Tan J-C, Lin P-S, He L-X, Lin Y, Yao Y-T, Evidence in Cardiovascular Anesthesia (EICA) Group. Anesthetic management of patients undergoing mediastinal mass operation. Front Surg. 2022;9:1033349.

  6. MacGillivray RG. Tracheal compression caused by aneurysms of the aortic arch: implications for the anaesthetist. Anaesthesia. 1985;40:270–277.

  7. Tempe DK, Arya R, Dubey S, Khanna S, Tomar AS, Grover V, et al. Mediastinal mass resection: femorofemoral cardiopulmonary bypass before induction of anesthesia in the management of airway obstruction. J Cardiothorac Vasc Anesth. 2001;15:233–236.

  8. Kar P, Malempati AR, Durga P, Gopinath R. Institution of cardiopulmonary bypass in an awake patient for resection of tracheal tumor causing near total luminal obstruction. J Anaesthesiol Clin Pharmacol. 2018;34:409–11. https://doi.org/10.4103/joacp.JOACP_352_15.

  9. Tran C, Aguirre M, Dellaria S, Wanat-Hawthorne A. Initiation of cardiopulmonary bypass in a high-risk patient under regional anesthesia: a case report. A A Pract. 2020;14: e01246.

Download references

Funding

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tarun Shetty.

Ethics declarations

Ethics committee approval

Not applicable.

Statement of human and animal rights

Not applicable.

Informed consent

Informed consent has been taken from the patient prior to the operative procedure.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in the manuscript.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shetty, T., Aironi, B., Kulkarni, D. et al. Institution of cardiopulmonary bypass in an awake patient for resection of isolated intrathoracic right subclavian artery aneurysm causing near total compression of the trachea. Indian J Thorac Cardiovasc Surg (2024). https://doi.org/10.1007/s12055-024-01735-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12055-024-01735-4

Keywords

Navigation