The Importance of the Airway in Children Undergoing Surgery for Congenital Heart Disease

Houska, Nicholas; Twite, Mark; Ing, Richard J.

doi:10.1053/j.jvca.2020.09.089

Cited by 4 publications

(3 citation statements)

References 27 publications

(23 reference statements)

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“…Airway abnormalities are often associated with CHD and encompass the entire spectrum, including structural airway anomalies and obstruction due to various causes 1,2 . These must be recognized early in such children to identify potential difficulty in intubation as a part of the preoperative evaluation and rule out airway narrowing as a cause of respiratory difficulty and worsening hemodynamic status 11,12 …”

Section: Discussionmentioning

confidence: 99%

“…1,2 These must be recognized early in such children to identify potential difficulty in intubation as a part of the preoperative evaluation and rule out airway narrowing as a cause of respiratory difficulty and worsening hemodynamic status. 11,12 With the availability of ultrafast scanners, CTA is the investigation of choice to concomitantly evaluate both the airways and the cardiac structures on a single scan. In our study, all the components of the airway, from the trachea to the lobar bronchi, showed some degree of luminal compromise due to extrinsic reasons, the most important being vascular etiologies.…”

Section: Interobserver Agreementmentioning

confidence: 99%

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Tracheobronchial abnormalities on computed tomography angiography in children with congenital heart disease

Bhatia,

Mathew

et al. 2024

Pediatric Pulmonology

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ObjectivesTo evaluate the assortment of tracheobronchial abnormalities on computed tomography angiography (CTA) in children with congenital heart disease (CHD).MethodsIn this study approved by the Institute ethics committee, CTA studies of 182 children (age range: 2 days–8 years) with CHD, performed from July 2021 to March 2023 were analyzed. Two pediatric radiologists independently assessed the tracheobronchial airways (from the trachea to lobar bronchi) for developmental and branching anomalies and airway compromise (narrowing). In cases which demonstrated airway compromise, the extent and the cause of airway narrowing were evaluated, and the etiology were divided into extrinsic and intrinsic causes. Interobserver agreement between the two radiologists was calculated using kappa statistics.ResultsOne hundred children demonstrated normal airway anatomy and no luminal narrowing. Airway narrowing was observed in 63 (34.6%) children (κ: 0.954), and developmental airway anomalies were seen in 32 (17.5%) children (κ: 0.935). Of the 63 children with airway narrowing, 47 (25.8%) children had extrinsic cause for narrowing, 11 (6%) children had intrinsic causes for narrowing, and 5 (2.7%) children had both intrinsic and extrinsic causes attributing to airway compromise. Significant airway narrowing (>50% reduction) was seen in 35 (19.2%) children (κ: 0.945).ConclusionTracheobronchial airway abnormalities are frequently associated in children with CHD and need to be appraised preoperatively. Cross‐sectional imaging with CTA provides excellent information on tracheobronchial airway anatomy and caliber as well as delineates the possible etiology of airway narrowing, thus accurately diagnosing airway anomalies.

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Section: Discussionmentioning

confidence: 99%

Section: Interobserver Agreementmentioning

confidence: 99%

Tracheobronchial abnormalities on computed tomography angiography in children with congenital heart disease

Bhatia,

Mathew

et al. 2024

Pediatric Pulmonology

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“…Neonates with congenital cardiac lesions experienced difficulties in intubation, desaturation, chronic lung disease (CLD) and intraoperative hypotension. It is thought that there is a strong relationship between the embryological development of the cardiac and respiratory structures, so that an abnormality in one may be associated with an abnormality in the other [ 15 ]. Additionally, the presence of CHD and an associated genetic disorder should alert the clinician to a high likelihood of an airway abnormality [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

The Phenotypical Profile and Outcomes of Neonates with Congenital Tracheoesophageal Fistula Associated with Congenital Cardiac Anomalies Presenting for Surgery

et al. 2022

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(1) Background: Neonates born with oesophageal atresia and/or tracheooesophageal fistula (OA/TOF) are usually born with a multitude of other congenital anomalies, which may affect their anaesthetic care and survival to hospital discharge. We reviewed the profile and outcome of neonates with OA/TOF and associated congenital cardiac anomalies presenting for surgery at an academic hospital in South Africa. (2) Methods: A retrospective, cross-sectional analysis of all medical records of neonates who had undergone surgical repair of OA/TOF was conducted at an academic hospital between January 2015 and December 2019. Descriptive statistics were used to report the data. Comparisons in perioperative events and outcomes between those with cardiac lesions and those without were done. (3) Results: Neonates presenting for OA/TOF repair with congenital cardiac defects had an incidence of 62 [95% CI 38.5–99.8] per 1000 days since birth. In total, 45.9% had associated cardiac anomalies, with PDA and ASD as the most prevalent lesions. There were statistically significant differences in intraoperative adverse events seen in neonates with congenital cardiac lesions as compared to those without. (4) Conclusion: Despite advances in neonatal critical care and anaesthetic and surgical techniques, OA/TOF associated with congenital cardiac anomalies is still associated with high mortality rates in developing countries.

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Airway abnormalities associated with congenital heart disease

Newman

2022

Pediatr Radiol

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The Importance of the Airway in Children Undergoing Surgery for Congenital Heart Disease

Cited by 4 publications

References 27 publications

Tracheobronchial abnormalities on computed tomography angiography in children with congenital heart disease

Tracheobronchial abnormalities on computed tomography angiography in children with congenital heart disease

The Phenotypical Profile and Outcomes of Neonates with Congenital Tracheoesophageal Fistula Associated with Congenital Cardiac Anomalies Presenting for Surgery

Airway abnormalities associated with congenital heart disease

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