Year : 2010  |  Volume : 13  |  Issue : 1  |  Page : 69-

A tracheal septum during routine pre-operative work-up


Gerard J Fitzmaurice, Abdul Nasir, Simon MacGowan 
 Department of Cardiac Surgery, The Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, United Kingdom

Correspondence Address:
Gerard J Fitzmaurice
Department of Cardiac Surgery, The Royal Victoria Hospital, Grosvenor Rd., Belfast, BT12 6BA, N. Ireland
United Kingdom




How to cite this article:
Fitzmaurice GJ, Nasir A, MacGowan S. A tracheal septum during routine pre-operative work-up.Ann Card Anaesth 2010;13:69-69


How to cite this URL:
Fitzmaurice GJ, Nasir A, MacGowan S. A tracheal septum during routine pre-operative work-up. Ann Card Anaesth [serial online] 2010 [cited 2022 May 25 ];13:69-69
Available from: https://www.annals.in/text.asp?2010/13/1/69/58839


Full Text

Routine pre-operative investigations are an integral part of preparation for cardiac surgery. We describe a 72-year-old gentleman, with severe mitral regurgitation, who was admitted electively for mitral valve repair. The physical examination was in keeping with this diagnosis. A routine pre-operative posterior-anterior chest radiograph (X-ray) gave the impression of a tracheal septum [Figure 1]. Following discussion and review with the anesthetic team, this unusual finding led to his surgery being postponed. The radiographs were discussed at length with the radiology team who advised a lateral chest radiograph. This confirmed a normal trachea and we were assured that the vertical stripe in the superior mediastinum actually represented a pleural junctional line or pleural reflection.

The consensus opinion of the radiology team was that no further imaging or direct visualisation of the trachea was necessary. To our knowledge, a tracheal septum or double trachea has never been reported in humans, however, it has been reported previously in penguins and sea lions. [1] In the event of a tracheal septum being encountered during intubation, the plan (dependent on the level of the tracheal septum and its structure) was to attempt intubation as normal if possible or intubation of one or both lumens of the tracheal septum with smaller endo-tracheal tubes. However, his intubation demonstrated a normal trachea and his surgery and subsequent recovery were uneventful.

References

1Zeek PM. Double trachea in penguins and sea lions. Anat Rec 2005;111:327-43.