Successful slide tracheoplasty and partial atrioventricular septal defect repair following extracorporeal membrane oxygenation support

Kelleher, Eoin; Nölke, Lars; McMahon, Colin J.

doi:10.1017/s1047951114000468

Cited by 4 publications

(4 citation statements)

References 10 publications

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“…In cases of severe congenital tracheal stenosis, surgical management is indicated. In reviewed case reports on congenital tracheal stenosis in DS children, a slide tracheoplasty is performed to treat severe tracheal stenosis 12–14 . Unfortunately, slide tracheoplasty demonstrated a poorer quality of life in children with noncardiac congenital comorbidities like DS when compared to children with isolated stenosis or healthy controls 15 .…”

Section: Resultsmentioning

confidence: 99%

Tracheal anomalies associated with Down syndrome: A systematic review

Fockens

Hölscher

Limpens

et al. 2021

Pediatric Pulmonology

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Introduction Airway anomalies are accountable for a substantial part of morbidity and mortality in children with Down syndrome (DS). Although tracheal anomalies occur more often in DS children, a structured overview on the topic is lacking. We systematically reviewed the characteristics of tracheal anomalies in DS children. Methods A MEDLINE and EMBASE search for DS and tracheal anomalies was performed. Tracheal anomalies included tracheal stenosis, complete tracheal ring deformity (CTRD), tracheal bronchus, tracheomalacia, tracheal web, tracheal agenesis or atresia, laryngotracheoesophageal cleft type 3 or 4, trachea sleeve, and absent tracheal rings. Results Fifty‐nine articles were included. The trachea of DS children is significantly smaller than non‐DS children. Tracheomalacia and tracheal bronchus are seen significantly more often in DS children. Furthermore, tracheal stenosis, CTRD, and tracheal compression by vascular structures are seen regularly in children with DS. These findings are reflected by the significantly higher frequency of tracheostomy and tracheoplasty performed in DS children. Conclusion In children with DS, tracheal anomalies occur more frequently and tracheal surgery is performed more frequently than in non‐DS children. When complaints indicative of tracheal airway obstruction like biphasic stridor, dyspnea, or wheezing are present in children with DS, diagnostic rigid laryngotracheobronchoscopy with special attention to the trachea is indicated. Furthermore, imaging studies (computed tomography, magnetic resonance imaging, and ultrasound) play an important role in the workup of DS children with airway symptoms. Management depends on the type, number, and extent of tracheal anomalies. Surgical treatment seems to be the mainstay in severe cases.

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Section: Resultsmentioning

confidence: 99%

Tracheal anomalies associated with Down syndrome: A systematic review

Fockens

Hölscher

Limpens

et al. 2021

Pediatric Pulmonology

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“…As reported in several previous studies, significant cardiac defects can be corrected by the same surgical procedure, the most common association being pulmonary arterial sling. [12][13][14][15][16][17][18] Some centres have even undertaken repair of congenital tracheal stenosis in the setting of a single lung. 19,20 We advocate a single national centre for operating on these children given the complexity of the airway and often coexistent cardiac defects.…”

Section: Discussionmentioning

confidence: 99%

“…21 We employed pre-operative extra-corporeal life support in seven children with a late presentation of tracheal stenosis who developed profound respiratory compromise. 16 Lastly, 3D printed models may supplement the data derived from CT and microlaryngobronchoscopy in the pre-operative planning for this complex cohort of patients. The use of multiple imaging modalities may supplement each other in providing the surgical team with the best strategy for surgical repair.…”

Section: Discussionmentioning

confidence: 99%

Outcome of congenital tracheal stenosis in children over two decades in a national cardiothoracic surgical unit

et al. 2019

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Objective:To assess the outcomes of congenital tracheal stenosis among children.Materials and methods:A retrospective review of all children who underwent surgical repair of congenital tracheal stenosis reviewing charts, operative notes, echocardiograms, CT and MRI data from January 2002 to February 2019.Results:Twenty-six children underwent surgical treatment for tracheal stenosis. The median age was 3 months (range 0.3–35 months) and the median weight was 4.7 kg (range 2.5–13 kg) at the time of surgical intervention. Stridor was the most common presenting symptom in 17 patients (65% of patients). Twenty-one patients (81%) had concurrent cardiac anomalies, with pulmonary arterial sling being the most common, present in nine patients (34%). Extracorporeal life support was utilised in seven patients (27%) pre-operatively. Laryngeal release was required in 16 patients. In 7 patients an end-to-end anastomosis was performed, in 18 patients slide tracheoplasty, and 1 patient had a double slide tracheoplasty. The median cardiopulmonary bypass time was 106 minutes (range 25–255 minutes). The median cross-clamp time was 30 minutes (range 5–67 minutes). The median post-operative duration of ventilation was 5 days (range 0.5–16 days). The median ICU length of stay was 12.5 days (range 2–60 days). There were three hospital mortalities with 88% survival. One patient only required reintervention with balloon dilation. Twenty-two patients (85%) remained symptom-free on median follow-up at 7.6 years (range 0.2–17 years). Two patients since 2017 had 3D printed tracheas produced from CT imaging to assist surgical planning.Conclusion:Congenital tracheal stenosis can be managed effectively with excellent outcomes and 3D printed models assist in planning the optimal surgical intervention.

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“…In planning for surgery, it is ideal if cardiac surgery can be performed at the same time as tracheal repair, but in certain cases, an endoscopic bronchial stent may need to be placed as a temporizing measure in those patients with persistent symptoms [14,15]. In certain cases, the diagnosis could be missed for years as initial airway symptoms could be mild but could result in acute decompensation as exemplified in a previously reported case [16].…”

Section: Discussionmentioning

confidence: 99%

Tracheal Stenosis and Congenital Heart Disease in Trisomy 21

Kylat

2019

Children

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Tracheal rings (TR) are rare, congenital cartilaginous defect of the upper airway and are usually due to complete or near complete circumferential cartilaginous tracheal rings, with variable degrees of tracheal stenosis (TS) and shortening. Chromosomal anomalies like trisomy 21 are characteristically associated with a wide range of upper airway anomalies including TS and congenital heart disease (CHD). However, the overall prevalence of severe forms of TS is rare and reported in 1.2% of all CHD patients. Herein, we present a rare association of severe TS due to complete tracheal rings in a trisomy 21 patient with CHD and the challenges in the management.

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Successful slide tracheoplasty and partial atrioventricular septal defect repair following extracorporeal membrane oxygenation support

Cited by 4 publications

References 10 publications

Tracheal anomalies associated with Down syndrome: A systematic review

Tracheal anomalies associated with Down syndrome: A systematic review

Outcome of congenital tracheal stenosis in children over two decades in a national cardiothoracic surgical unit

Tracheal Stenosis and Congenital Heart Disease in Trisomy 21

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