Anesthetic Management in an Unanticipated Difficult Airway Because of Oropharyngeal Stenosis in a Patient With Pierre Robin Syndrome Undergoing Pediatric Congenital Heart Surgery: A Case Report

Background: Difficult intubation in pediatric patients with a history of relatively common respiratory and cardiac problems and syndromic cases should always be considered. Pierre Robin syndrome is a rare birth defect characterized by a small jaw, tongue retraction, and upper airway obstruction, also known as Pierre Robin syndrome. Case Report: We describe a 5-month-old boy, 3500 g in weight, suffering from Pierre Robin syndrome. The patient was a candidate for the surgical closure of ventricular septal defect (VSD) and patent ductus arteriosus (PDA). After the induction of anesthesia in the operating room, we encountered problems with intubation in that it was not possible to secure an airway with a tracheal tube via different methods. The patient woke up, and the surgery was postponed. His airway was then thoroughly evaluated before VSD and PDA surgical closure was performed successfully.Conclusions: In elective surgical cases with unexpectedly challenging intubation, the surgery should be postponed until the airway is fully checked and a safe airway is secured. (Iranian Heart Journal 2023; 24(3): 94-99)