Anesthetic Management of Unanticipated Subglottic Stenosis in a Patient Undergoing Coronary Artery Bypass Graft Surgery

Authors

Claudia Wei
Dominique Wreh
Jacy Gressen
Anvinh Nguyen

Publication Date

3-1-2024

Journal

Cureus

DOI

10.7759/cureus.56110

PMID

38618313

PMCID

PMC11014738

PubMedCentral® Posted Date

3-13-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

left main coronary artery disease (lmcad), prolonged intubation, difficult airway management, airway dilation, subglottic stenosis

Abstract

A 62-year-old female presented for a scheduled coronary artery bypass graft (CABG) and was found to have an unexpected subglottic stenosis during routine intubation. The case was aborted and six days later, the patient underwent lasering of the stenotic subglottic region and airway balloon dilation. In this case report, causes of subglottic stenosis and surgical/anesthetic management of the condition are discussed. The management of subglottic stenosis in this patient was complicated by concurrent severe coronary artery disease (CAD) involving the left main coronary artery and timing of airway surgery relative to interventions for her CAD. In situations of undiagnosed subglottic stenosis, anesthesiologists should be familiar with airway management based on the location and severity of the stenosis. Close multidisciplinary team management is required for patients who have other complex comorbidities.