Long, severe, and fixed congenital tracheal stenosis is a life-threatening anomaly and not relieved by endotracheal or tracheostomy intubation. The rarity of congenital tracheal stenosis has not allowed sufficient experience for the development
of
standard treatment methods, therefore, congenital tracheal stenosis still carries significant morbidity, with a mortality rate as high as 70%.
We have followed up two patients managed by different methods, but O2-isoflurane-Fentanyl-vecuronium was used for induction and maintenace. We experienced one case of tracheoplasty with pericardial patch for extensive tracheal stenosis under
extracorporeal circulation. and one case of slide tracheoplasty of funnel-shaped tracheal stenosis. The first case was noticed incidentally during anesthetic induction and the vocal cord was visible but 2.5 mm sized tube could not be advanced, so
we
used the guide wire which is used for central line, then we could intubate with some resistance. Tracheostomy was not allowed due to diffuse tracheal stenosis reaching from cricoid cartilage to carina. During the extra corporial circulation, the
guide
wire was inserted from cricoid cartilage to carina. During the extra corporial circulation, the guide wire was inserted from operation field, and 3.5 mm sized tube was introduced via guide wire by anesthesiologist. After operation the
grannulation
tissue that obstructing airway, was noticed by bronchoscopy, and was removed, then he was weaned from ventilator successfully. The second case was discovered due to diffcult weaning from ventilator after open heart surgery. The bronchogrm showed
right
tracheal bronchus and diffuse tracheal stenosis from T2 to carina. He was ventilated initially with 4.0 mm sized endotracheal tube, and ventilated intermittently with other 2.5 mm sized endotracheal tube from operation field during tracheal
anastomosis.
After operation, he died with increased airway pressure and airway bleeding.
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