Simultaneous management of congenital tracheal stenosis and cardiac anomalies in infants

Loukanov, Tsvetomir; Sebening, Christian; Springer, W; Ulmer, Herbert E.; Hagl, S.

doi:10.1016/j.jtcvs.2005.08.031

Cited by 45 publications

(38 citation statements)

References 11 publications

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“…Only a few case reports have focused on LPAS with TOF, DORV, or PAPVC3161718. Consistent with previous reports, our study showed one case each with PAPVC and TOF.…”

Section: Discussionsupporting

confidence: 92%

Evaluation of left pulmonary artery sling, associated cardiovascular anomalies, and surgical outcomes using cardiovascular computed tomography angiography

Xie

Juan

Wang

et al. 2017

Sci Rep

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We evaluated the prevalence, image appearance, associated cardiovascular anomalies, and surgical outcomes of left pulmonary artery sling (LPAS) using cardiovascular computed tomography angiography (CCTA). A retrospective search of patients from our database between October 2007 and December 2014 identified 52,200 patients with congenital heart diseases (CHD) referred for CCTA, echocardiography, or magnetic resonance imaging. Clinical information, CCTA findings, associated cardiovascular anomalies, and surgical outcomes were analyzed. We showed a hospital-based prevalence of 71 patients with LPAS (0.14%, 71/52,200) among CHD patients. Of these, 47 patients with CCTA examinations were assessed further. Most patients (40/47, 85%) had associated cardiovascular anomalies, of which ventricular septal defects (22/47, 47%), atrial septal defects (20/47, 43%), patent ductus arteriosus (16/47, 34%), persistent left superior vena cava (14/47, 30%), and abnormal branching of the right pulmonary artery (ABRPA) (14/47, 30%) were most commonly identified. In total, 28 patients underwent LPA reanastomosis and/or tracheoplasty in our center, and 5 died. LPAS had a hospital-based prevalence of 0.14% among CHD patients. ABRPA is not uncommon and must be recognized. CCTA is a feasible method for demonstrating LPAS and its associated cardiovascular anomalies for an optimal pre-operative assessment of LPAS.

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“…Only a few case reports have focused on LPAS with TOF, DORV, or PAPVC3161718. Consistent with previous reports, our study showed one case each with PAPVC and TOF.…”

Section: Discussionsupporting

confidence: 92%

Evaluation of left pulmonary artery sling, associated cardiovascular anomalies, and surgical outcomes using cardiovascular computed tomography angiography

Xie

Juan

Wang

et al. 2017

Sci Rep

View full text Add to dashboard Cite

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“…Recent studies reported that slide tracheoplasty was a preferred method for long-segmental stenosis [10,11]. And several studies demonstrated that simultaneous repair of CTS and cardiac anomalies is a reasonable surgical approach [12,13]. But staged correction may be considered in infants with long-segment CTS and complex cardiac anomalies because those still remain difficult to treat [5].…”

Section: Discussionmentioning

confidence: 99%

Severe airway obstruction in an infant with congenital tracheal stenosis and congenital heart disease -A case report-

Kim

Yoon

Kim

et al. 2012

Korean J Anesthesiol

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Congenital tracheal stenosis (CTS), though rare, is important because the mortality and morbidity rates are high in infants. Especially, associated congenital heart disease (CHD) in these infants may compound the effects of airway pathology. A 3-week-old patient with long-segmental tracheal stenosis below an anomalous right-upper lobe (RUL) bronchus had undergone a total correction of double outlet right ventricle. On third postoperative day, hypercarbia developed, and severe airway obstruction and atelectasis were detected. An emergency slide tracheoplasty was performed under cardiopulmonary bypass (CPB). The patient recovered well after the surgery. Thus, special attention needs to be paid during the postoperative intensive care of patients with congenital tracheal anomalies. Early detection and prompt diagnosis of airway obstruction can help reduce the morbidity and mortality rates. Further, it is important to select the suitable treatment of CTS associated with CHD.

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“…If an airway obstruction in infants with CHD undergoing surgical intervention is not resolved simultaneously, the majority of such children will remain dependent on a breathing machine as long as 7 days [Elliott et al 2003;Loukanov et al 2005]. In this study, we carried out radical surgical intervention for CHD and attempted to withdraw patients from the breathing machine, but it was unsuccessful due to associated airway obstruction in 22 patients.…”

Section: Discussionmentioning

confidence: 99%

Emergency management for congenital tracheal stenosis with endoluminal stenting in pediatric intensive care units

Xing

Ding²,

Liu

et al. 2016

Ther Adv Respir Dis

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Objective: The objective of this study was to share our experience in the management of congenital tracheal stenosis (CTS) using self-expanding intraluminal stents in infants. Methods: From January 2010 to August 2012, 31 infants with CTS treated using stents by bronchoscope in pediatric intensive care units (PICUs) were recruited for this study. Results: Among the 31 patients, 17 were male and 14 were female with their ages ranging from 55 days to 22 months. CTS was associated with congenital heart disease (CHD) in 22 patients. There were no immediate stent-related airway complications. A significant and immediate improvement of respiratory obstruction following stent placement in all 31 patients led to successful weaning from the breathing machine and extubation. Granulation tissue formation as a complication was observed in three (9.7%) patients, but all were successfully managed using cryotherapy. During follow up (up to 24 months), stents in 29 infants remained functional. In seven cases, stents were retrieved under bronchoscope (the same day to 10 months), and three cases required stent replacement (each of the three cases had the stent replaced three times). Nine infants died after stenting due to other causes and two infants abandoned treatment. Conclusion: Airway stenting may provide an important therapeutic option in infants with CTS.

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Simultaneous management of congenital tracheal stenosis and cardiac anomalies in infants

Abstract: We advocate our current strategy for infants with congenital tracheal stenosis: resection with end-to-end anastomosis and simultaneous repair of associated intracardiac anomalies.

Cited by 45 publications

References 11 publications

Evaluation of left pulmonary artery sling, associated cardiovascular anomalies, and surgical outcomes using cardiovascular computed tomography angiography

Evaluation of left pulmonary artery sling, associated cardiovascular anomalies, and surgical outcomes using cardiovascular computed tomography angiography

Severe airway obstruction in an infant with congenital tracheal stenosis and congenital heart disease -A case report-

Emergency management for congenital tracheal stenosis with endoluminal stenting in pediatric intensive care units

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