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

## TL;DR

This case report discusses the anesthetic and surgical challenges of managing an unexpected airway blockage in a patient with severe heart disease.

## Contribution

The paper presents a novel case highlighting the complexities of managing subglottic stenosis alongside severe coronary artery disease.

## Key findings

- Subglottic stenosis was discovered during routine intubation for CABG surgery.
- Airway surgery was performed before addressing the patient's coronary artery disease.
- Multidisciplinary team coordination is essential in managing complex comorbidities.

## 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.