A two-year-old child was hospitalized with a diagnosis of laryngotracheo-bronchitis. His airway symptoms, however, were the presenting manifestations of superior vena caval thrombosis around a ventriculoatrial shunt. Subglottic edema obstructed his airway initially; this was relieved by tracheostomy. Later, progressive tracheobronchial compression from the dilated superior vena cava and its collateral vessels almost proved fatal. Removal of the shunt allowed blood to flow through the thrombus. This relieved the patient's severe respiratory distress within hours.
Letter: Transesophageal Echocardiography-Guided Ventriculoatrial Shunt Insertion
