A 65-year-old man with tracheobronchopathia osteochondroplastica was referred to our hospital for exertional dyspnea and was diagnosed with atrial septum defect( ASD). We planned to close the ASD under intubation but were unable to intubate due to osseous nodules in the tracheal wall. Four months later, the patient was successfully intubated using an endotracheal tube introducer. Thus, we were able to complete closure of ASD under cardiac-pulmonary bypass.