Anterior Mediastinal Masses, Oesophageal Surgery, and Complex Tracheobronchial Procedures — WACS Viva & Clinical Scenarios (Cardiothoracic)

Exam-style anterior mediastinal masses, oesophageal surgery, and complex tracheobronchial procedures viva scenarios with examiner probes and model answers for…

Scenarios covered

• SCENARIO 1: A 24-year-old male (ASA III) presents with facial swelling, engorged neck veins, severe orthopnoea, and a large anterior mediastinal mass compressing the distal trachea by 60% on CT scan. He is booked for biopsy under general anaesthesia. How do you assess, prepare, and anaesthetise this patient to prevent total cardiovascular and respiratory collapse?
• SCENARIO 2: A 3-year-old child presents with sudden onset of stridor, wheezing, and a history of foreign body aspiration (peanut) lodged in the right main bronchus. The surgeon requests general anaesthesia for rigid bronchoscopy and optical forceps extraction. Outline your complete anaesthetic and airway management plan.
• SCENARIO 3: A 56-year-old male (ASA III) with middle-third oesophageal carcinoma undergoes an Ivor Lewis subtotal oesophagectomy (laparotomy and right thoracotomy). Detail your intraoperative management, lung isolation strategy, fluid restriction protocols, and postoperative analgesia plan.
• SCENARIO 4: A 32-year-old male with post-tracheostomy tracheal stenosis 2 cm below the vocal cords is posted for tracheal resection and primary anastomosis. Explain how airway control is maintained from induction, through surgical division of the trachea, to final extubation.