Endobronchial stenting on VV-ECMO in a 6-month-old girl with right lung agenesis and severe stenosis of the left main bronchus

Perfusion. 2018 Oct;33(7):599-601. doi: 10.1177/0267659118768153. Epub 2018 Apr 15.

Abstract

Introduction: Lung agenesis is a rare disorder with a variable, but potentially very bad clinical course. It necessitates complex clinical management, especially in life-threatening situations.

Case report: We describe a case of a 6-month-old girl with right lung agenesis who required venovenous extracorporeal membrane oxygenation (VV-ECMO) due to pneumonia complicated by exacerbated previously diagnosed left main bronchus stenosis. The stenosis was resolved by endobronchial intervention and X-ray-guided stent insertion, which enabled weaning from ECMO and was aimed at preventing such a life-threatening respiratory failure in the future. Unfortunately, even with the functional stent, the baby died 2 months post-procedure due to unresolvable bronchial spasms.

Discussion: Despite high endobronchial stenting-related mortality in children, in cases where no effective pharmacological or surgical alternatives exist, stenting may be safely performed during VV-ECMO support and be a viable option to overcome critical respiratory failure caused by bronchial stenosis.

Keywords: airway stent; lung agenesis; paediatric VV-ECMO.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abnormalities, Multiple / surgery*
  • Bronchi / abnormalities*
  • Extracorporeal Membrane Oxygenation / methods*
  • Female
  • Humans
  • Infant
  • Lung / abnormalities*
  • Lung / surgery
  • Lung Diseases / surgery*
  • Respiratory Insufficiency / pathology
  • Respiratory Insufficiency / surgery*

Supplementary concepts

  • Lung agenesis