Alan G. Dawson

Sudden Loss of Ventilation Through a Double-Lumen Endotracheal Tube Requiring a Surgical Bronchotomy

A left completion pneumonectomy for primary lung cancer (left lower lobectomy) was complicated by sudden loss of ability to ventilate the patient through the double-lumen endotracheal tube. The problem could not be overcome by the anesthesiologist. In the face of impending cardiorespiratory arrest, a single-lumen tube was introduced through an incision in the left main bronchus through to the right main bronchus. This life-saving maneuver safeguarded the airway and permitted a successful outcome to the operation.

Sudden loss of ventilation through a double lumen endotracheal tube requiring emergency provision of a surgical airway by bronchotomy

A left completion pneumonectomy operation for primary lung cancer (left lower lobectomy) was complicated by sudden loss of ability to ventilate the patient via the double lumen endotracheal tube. The problem could not be overcome by the anesthesiologist. In the face of impending cardiorespiratory arrest a single lumen tube was introduced through an incision in the left main bronchus through to the right main bronchus. This life-saving manoeuvre safeguarded the airway and permitted a successful outcome to the operation.

Hypoplastic internal carotid artery stenosis with a low-lying carotid bifurcation causing cerebral ischemia

Congenital abnormalities of the internal carotid artery (ICA) are infrequent and can be associated with aberrations of the Circle of Willis. A 47-year-old gentleman presented with transient neurological symptoms and cerebral infarction and carotid Doppler showed a stenotic right ICA. Subsequent computed tomographic angiography showed a hypoplastic ICA with a low-lying bifurcation at the C6 level and aplasia of the anterior communicating artery. This patient was commenced on aggressive medical therapy and at 7-month follow-up was symptom-free. This case report highlights the need for a centralized registry with long-term follow-up data in order to identify optimal management.