Lung isolation in an infant is a challenge. 6 months old male baby diagnosed to have congenital cystic adenomatoid malformation right lung was posted for lobectomy where we planned for lung isolation.

Baby was induced and mask ventilated with less tidal volume to prevent rupture of bullae. With FOB guidance 5FR fogarty catheter was placed in right main bronchus via oral route. Then 3.5 size uncuffed endotracheal tube was placed in trachea. Surgery was performed in left lateral position. Intra operative findings were multiple cysts occupying rt upper and middle lobe which had bronchial communication. Rt upper & middle lobectomy done & air leak corrected. Thoracotomy closed with chest tube inside. Epidural catheter is placed in pleural cavity for post op pain relief. Baby reversed & put in T - piece & then extubated after one hour. Post op period uneventful.

Surgeon comfort, prevent seepage of infected material/blood into normal dependant lung, checking air leak intra operatively.

Fogarty embolectomy catheter is the best but difficult task in isolating lung in infants posted for thoracic surgery.