Abstract
Airway compression in older children is uncommon and becomes more challenging when thoracic deformities alter aortic anatomy. A 16-year-old girl with severe scoliosis and chronic bedridden status presented with progressive respiratory distress caused by compression of the left main bronchus between the ascending aorta and a right-sided descending aorta. As conventional aortopexy alone was unlikely to achieve adequate decompression, aortic elongation using a prosthetic graft was performed to reposition the descending aorta posteriorly, followed by aortopexy. Postoperative imaging confirmed complete bronchial decompression, and the patient’s respiratory symptoms resolved.