Tracheal Calcification Following Warfarin Administration: A Case Report

Sara Salarian; Sogol Asgari; Faranak Behnaz

doi:10.18502/aacc.v10i2.15069

Sara Salarian Department of Anesthesiology and critical Care, Imam Hosein Hospital, Shahid Beheshti University of Medical Sciences,Tehran, Iran.
Sogol Asgari Department of Anesthesiology, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Faranak Behnaz Department of Anesthesiology, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v10i2.15069

Keywords: Warfarin; Tracheobronchial calcification; Anticoagulant; Percutaneous dilution tracheostomy

Abstract

Warfarin ought to be utilized for an extended duration in individuals with a predisposition to thromboembolism, such as those with atrial fibrillation or aortic valve replacement. While the primary complication of long-term warfarin usage is the potential for bleeding, there are also infrequent complications like vascular and tracheal calcification. We present a case of a patient who experienced diffuse tracheal calcification as a result of long-term warfarin usage.

A 74-year-old female patient, who had been receiving chronic warfarin treatment for atrial fibrillation, required intubation and was admitted to the intensive care unit due to aspiration pneumonia. As the patient was unable to be extubated during the hospital stay, she became a candidate for Percutaneous dilution tracheostomy (PDT). It was discovered during the PDT procedure that all available spaces of the trachea above the sternum were calcified, preventing the passage of the trach needle. The presence of tracheal calcification was confirmed by both a radiologist and ultrasound examination.

Currently, individuals are compelled to employ oral anticoagulants, like warfarin, in order to avert thromboembolic diseases. Nevertheless, the protracted utilization of warfarin is linked with infrequent adverse outcomes, such as disseminated calcification. Consequently, meticulous scrutiny of these side effects is requisite for patients with enduring warfarin consumption.