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The role of flexible fibreoptic bronchoscopy in evaluation of pulmonary diseases in children with congenital cardiac disease

Published online by Cambridge University Press:  23 January 2007

Ori Efrati ,
Udi Gonik ,
Dalit Modan-Moses ,
Bella Bielorai ,
Asher Barak ,
Amir Vardi ,
Gideon Paret ,
David Mishaly  and
Amos Toren
Ori Efrati
Affiliation:
Pediatric Pulmonology Unit, Safra Children's Hospital, The Sheba Medical Center, Tel-Hashomer, affiliated to the Tel-Aviv University, Sackler School of Medicine, Tel-Aviv, Israel
Udi Gonik
Affiliation:
Pediatric Pulmonology Unit, Safra Children's Hospital, The Sheba Medical Center, Tel-Hashomer, affiliated to the Tel-Aviv University, Sackler School of Medicine, Tel-Aviv, Israel
Dalit Modan-Moses
Affiliation:
Pediatric Pulmonology Unit, Safra Children's Hospital, The Sheba Medical Center, Tel-Hashomer, affiliated to the Tel-Aviv University, Sackler School of Medicine, Tel-Aviv, Israel
Bella Bielorai
Affiliation:
Department of Pediatric-Hemato-Oncology and BMT, Safra Children's Hospital, The Sheba Medical Center, Tel-Hashomer, affiliated to the Tel-Aviv University, Sackler School of Medicine, Tel-Aviv, Israel
Asher Barak
Affiliation:
Pediatric Pulmonology Unit, Safra Children's Hospital, The Sheba Medical Center, Tel-Hashomer, affiliated to the Tel-Aviv University, Sackler School of Medicine, Tel-Aviv, Israel
Amir Vardi
Affiliation:
Department of Pediatric Intensive Care, Safra Children's Hospital, The Sheba Medical Center, Tel-Hashomer, affiliated to the Tel-Aviv University, Sackler School of Medicine, Tel-Aviv, Israel
Gideon Paret
Affiliation:
Department of Pediatric Intensive Care, Safra Children's Hospital, The Sheba Medical Center, Tel-Hashomer, affiliated to the Tel-Aviv University, Sackler School of Medicine, Tel-Aviv, Israel
David Mishaly
Affiliation:
Pediatric Cardiac Surgery Unit, Safra Children's Hospital, The Sheba Medical Center, Tel-Hashomer, affiliated to the Tel-Aviv University, Sackler School of Medicine, Tel-Aviv, Israel
Amos Toren
Affiliation:
Department of Pediatric-Hemato-Oncology and BMT, Safra Children's Hospital, The Sheba Medical Center, Tel-Hashomer, affiliated to the Tel-Aviv University, Sackler School of Medicine, Tel-Aviv, Israel
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Abstract

Background: Diseases of the lungs and airways can be life-threatening in patients with congenital cardiac disease. External compression, and tracheobronchomalacia, as well as pathology of the large airways, can cause respiratory symptoms such as wheezing, stridor, fever, and dyspnoea, along with producing difficulty to wean the patient from mechanical ventilation. A definite diagnosis may be achieved by fibreoptic flexible bronchoscopy. Aims: To characterize the patients who underwent bronchoscopy for respiratory diseases associated with congenital cardiac disease, and to evaluate the safety, total diagnostic rate, and diagnostic rate, which yielded alteration of treatment in this group of patients. Methods: We reviewed retrospectively the records of 39 patients with congenital cardiac disease associated with abnormalities of the airways who underwent 49 fibreoptic bronchoscopies between 1999 and 2004. The patients were evaluated with regard to rate of diagnosis, the rate of procedures that resulted in alteration of management, and the rate of complications. Results: Fibreoptic flexible bronchoscopy was safe, and contributed to a specific diagnosis in almost nine-tenths of the procedures. A specific diagnosis that resulted in treatment alteration was achieved in one-fifth of the procedures. Conclusions: Fibreoptic flexible bronchoscopy has an important role in the evaluation of pulmonary abnormalities in patients with congenital cardiac diseases, and should be considered as an initial diagnostic tool that may guide the clinician with regard to the proper therapy.

Keywords

Bronchoscopycardiac diseasebronchoalveolar lavageleft main bronchus compressionpneumoniaatelectasis
Type
Original Article
Information
Cardiology in the Young , Volume 17 , Issue 2 , April 2007 , pp. 140 - 144
Copyright
© 2007 Cambridge University Press

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