Infants with esophageal atresia and right aortic arch: Characteristics and outcomes from the Midwest Pediatric Surgery Consortium

Lal, Dave R.; Gadepalli, Samir K.; Downard, Cynthia D.; Minneci, Peter C.; Knezevich, Michelle; Chelius, Thomas; Rapp, Cooper T.; Billmire, Deborah F.; Bruch, Steven W.; Burns, Rebecca; Deans, Katherine J.; Fallat, Mary E.; Fraser, Jason D.; Grabowski, Julia; Hebel, Ferdynand; Helmrath, Michael A.; Hirschl, Ronald B.; Kabre, Rashmi; Kohler, Jonathan E.; Landman, Matthew P.; Leys, Charles M.; Mak, Grace Z.; Ostlie, Daniel J.; Raque, Jessica; Rymeski, Beth; Saito, Jacqueline M.; Peter, Shawn D. St.; Allmen, Daniel von; Warner, Brad W.; Sato, Thomas T.

doi:10.1016/j.jpedsurg.2018.08.002

Cited by 17 publications

(18 citation statements)

References 13 publications

(9 reference statements)

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“…Level A Recommendations 37,77,79,80,128 Definitive confirmation will require a CT-angiogram or an MRI/MRA or cardiac catheterization. prevents the complete collapse of the tracheal lumen.…”

Section: Evaluation Of Cyanosismentioning

confidence: 99%

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Koumbourlis

Belessis

Cataletto

et al. 2020

Pediatric Pulmonology

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Tracheoesophageal fistula (TEF) with esophageal atresia (EA) is a common congenital anomaly that is associated with significant respiratory morbidity throughout life. The objective of this document is to provide a framework for the diagnosis and management of the respiratory complications that are associated with the condition. As there are no randomized controlled studies on the subject, a group of experts used a modification of the Rand Appropriateness Method to describe the various aspects of the condition in terms of their relative importance, and to rate the available diagnostic methods and therapeutic interventions on the basis of their appropriateness and necessity. Specific recommendations were formulated and reported as Level A, B, and C based on whether they were based on “strong”, “moderate” or “weak” agreement. The tracheomalacia that exists in the site of the fistula was considered the main abnormality that predisposes to all other respiratory complications due to airway collapse and impaired clearance of secretions. Aspiration due to impaired airway protection reflexes is the main underlying contributing mechanism. Flexible bronchoscopy is the main diagnostic modality, aided by imaging modalities, especially CT scans of the chest. Noninvasive positive airway pressure support, surgical techniques such as tracheopexy and rarely tracheostomy are required for the management of severe tracheomalacia. Regular long‐term follow‐up by a multidisciplinary team was considered imperative. Specific templates outlining the elements of the clinical respiratory evaluation according to the patients’ age were also developed.

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“…Level A Recommendations 37,77,79,80,128 Definitive confirmation will require a CT-angiogram or an MRI/MRA or cardiac catheterization. prevents the complete collapse of the tracheal lumen.…”

Section: Evaluation Of Cyanosismentioning

confidence: 99%

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Koumbourlis

Belessis

Cataletto

et al. 2020

Pediatric Pulmonology

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“…Berthet et al 8 also report right aortic arch in 5 of 76 and aberrant right subclavian artery in 9 of 76 children, based on esophagram or echocardiogram findings. In the Midwest Pediatric Surgery Consortium, a right‐sided aortic arch was reported in 5% of 396 infants 18 . With collaborative care, it will be possible to understand if these vascular malformations associated with EA ± TEF are more common in those children who experience chronic respiratory symptoms.…”

Section: Discussionmentioning

confidence: 99%

Vascular and pulmonary comorbidities in children with congenital EA/TEF

Poore

Weinman

Handley

et al. 2020

Pediatric Pulmonology

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“…RLN injury during surgery for esophageal atresia (EA), tracheoesophageal fistula (TEF), and tracheobronchomalacia (TBM) is established in the literature as the RLN often courses through the operative field (Figure 1). The incidence ranges from 11 to 50% and varies by approach, the patient's anatomy, and concurrent cardiac procedures (8)(9)(10)(11)(12)(13). Identifying and protecting the RLN is particularly difficult in the surgery of neonates and in revision cases (13).…”

Section: Brief Historical Perspectivementioning

confidence: 99%

Intraoperative Recurrent Laryngeal Nerve Monitoring During Pediatric Cardiac and Thoracic Surgery: A Mini Review

et al. 2020

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Objective: Review techniques for intraoperative recurrent laryngeal nerve (RLN) monitoring during pediatric surgery for esophageal atresia, tracheoesophageal fistula, tracheobronchomalacia, and cardiac surgery.Summary Background Data: Literature was reviewed for reports of intraoperative recurrent laryngeal nerve monitoring in cervical, thoracic, and cardiac surgical procedures which place the RLNs at risk for injury.Methods: Review paper.Results: The RLN is at risk during pediatric surgery for esophageal atresia, tracheoesophageal fistula, tracheobronchomalacia, and cardiac surgery. Intraoperative nerve monitoring has decreased rates of RLN injury in thyroid surgery. Intraoperative RLN monitoring techniques appropriate for pediatric surgery are discussed, including endotracheal tubes with integrated surface electrodes, adhesive surface electrodes for smaller endotracheal tubes, endolaryngeal electrodes, and automatic periodic continuous intra-operative stimulation.Conclusions: Multiple techniques exist to monitor the RLN in children undergoing cervical, cardiac, and thoracic surgery. Monitoring the RLN during procedures that place the RLNs at risk may help decrease the rate of RLN injury.

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Infants with esophageal atresia and right aortic arch: Characteristics and outcomes from the Midwest Pediatric Surgery Consortium

Abstract: Level III.

Cited by 17 publications

References 13 publications

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Vascular and pulmonary comorbidities in children with congenital EA/TEF

Intraoperative Recurrent Laryngeal Nerve Monitoring During Pediatric Cardiac and Thoracic Surgery: A Mini Review

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