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2007, Number 4

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Rev Inst Nal Enf Resp Mex 2007; 20 (4)

Late presentation of plastic bronchitis after the Fontan procedure

Méndez OGJ, Carrasco FR, García MJ, Soto AMV, Jamaica BLMC, Maldonado TB, Núñez Pérez-Redondo C, Flores HSS

Language: Spanish
References: 19
Page: 274-279
PDF size: 137.71 Kb.


ABSTRACT

Plastic bronchitis is an unusual disorder due to the production and expectoration of long bronchial molds of lymphatic origin which can produce obstruction of the airway. It is mostly seen in the postoperative course of congenital heart disease treated by Fontan´s operation. It is treated basically with mucolytics and chest physiotherapy; the most serious cases require the removal of the bronchial molds by bronchoscopy and the use of aerosolized urokinase or tissue plasminogen activator. We describe a five year old boy treated by Fontan’s operation for cyanotic congenital heart disease. Eight months later he was hospitalized with frequent episodes of fever, dyspnea, wheezing, oxygen desaturation and cough with expectoration of light brown bronchial molds; he was treated with aerosolized n-acetylcysteine but as the obstruction persisted bronchoscopic extraction was done.
In this case report we show the usefulness of bronchoscopy associated to aerosol therapy for this entity.


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