This is a 45-year-old male patient with a history of smoking and hypercholesterolemia, suffering from severe acute coronary artery disease who underwent quadruple coronary artery bypass grafting with extracoronary circulation. Transesophageal echocardiography showed an ejection fraction of 8-10%.
The patient was intubated and kept on mechanical ventilation for 9 days in the intensive care unit (ICU). After extubation, he began to experience increased respiratory frequency, reduced oxygen saturation and oxyhaemoglobin values, so he was reintubated and reconnected to the mechanical ventilator, which was maintained until the twelfth day, when it could be definitively withdrawn. Once the patient's condition stabilised, he was transferred to the cardiology department.
On the eighth day on the ward he began to experience dyspnoea, stridor, intense respiratory work and tachypnoea, for which he was again transferred to the ICU. Given the symptoms of upper airway obstruction, an urgent fibrobronchoscopy was performed, which revealed complex tracheal stenosis. A cervical computed tomography (CT) scan showed tracheal stenosis at the proximal end of 66% at approximately 2 cm from the glottis with peritracheal fibrosis and a 5 mm lumen.

It was decided to perform rigid bronchoscopy to place a tracheal prosthesis. Rigid bronchoscopy was combined with Nd-YAG laser therapy on the lesion and subsequent mechanical resection with a rigid bronchoscope. After tracheal recanalisation, a silicone prosthesis (Dumon 14/40) is placed, which is correctly anchored and permeable with the proximal end about 2.5 cm from the cords and the distal end about 7 cm from the carina. At the 7-day check-up, the prosthesis is still fully permeable and the respiratory symptoms have been definitively resolved.