Tracheoaortopexy via midline sternotomy in tracheomalacia

Tracheomalacia and Tracheobronchomalacia in Children and Adults

“…In this procedure, the ascending aorta is approached traditionally through a rightsided anterior thoracotomy at the third intercostal space 23,132 or through alternative routes. 7,[133][134][135][136] Traction on the sutures placed in the wall of the aorta juxtaposes it to the undersurface of the sternum, which also pulls the anterior wall of the trachea forward. This mechanical fixation of the aorta widens the anterioposterior dimensions of the trachea and prevents collapse.…”

Thoracoscopic aortopexy for primary tracheomalacia in a 12-year-old

“…Indications for operative intervention include a single dying spell, the need for endotracheal intubation to maintain a functional airway, or 3 or more documented instances of pneumonia [1]. Various approaches have been described including the left lateral thoracotomy, midline sternotomy, mediastinal window, and an anterior cervical approach [11,12]. However, these all involve more extensive surgery and a longer postoperative recovery time.…”

Anaesthesia for thoracic surgery in children

“…Aortopexy is performed either through a sternotomy or a left thoracotomy. Suturing the adventitia of the overlying aorta to the sternal periostium ( 93,94) elevates the anterior trachea. Intraoperative observation of the malacic area through a fibreoptic bronchoscope confirms the effectiveness or otherwise of the procedure.…”