Stenting of the mainstem bronchus in children: a word of caution

We present two patients with critical hemorrhage following expandable metallic stenting of the left mainstem bronchus in children. Stent migration with erosion into a bronchial artery leading to mycotic pseudoaneurysm formation and overwhelming pulmonary hemorrhage occurred in both patients. One patient died from uncontrollable hemoptysis. The second patient was salvaged by left pneumonectomy and patch repair at the site of mycotic aortic rupture. Stenting of a mainstem bronchus, particularly in cyanotic children must be approached with extreme caution.