Ventilation problems in two children with congenital heart and great arteries defects

Direct pressure on trachea and bronchi by anatomical defects and changed elements of the circulatory system in infants suffering from congenital heart diseases is problem of special interest for anaesthesiologist. This process ,already initiated ‘in utero ’,results in damage of cartilaginous structure of trachea and bronchi. The loss of their mechanical properties and their flaccidity increase steadily in such cases. Finally mechanical disorders of ventilation occur, and become critical during child ’s spontaneous breathing or anxiety. Intubation and positive pressure mechanical ventilation not always corrects the flow and gas exchange. Sometimes even after successful cardiosurgical correction , normal properties of trachea and bronchi are not regained. These problems are quite typical in two congenital diseases: the aortic defect –‘vascular ring ’,and aneurysmal pulmonary arteries syndrome. We have found that diagnostic process and therapy of such children is very difficult. Stenosis of the trachea resulting from pressure by the vascular ring was diagnosed in one of our patients, the second one patients suffered from the aneurismal pulmonary arteries syndrome. After cardiac corrective surgery the long-lasting, complex intensive care was successful in both cases.

Keywords: congenital heart disease, infants