Surgical Reconstruction of Tracheal Stenosis in Conjunction With Congenital Heart Defects

Mainwaring, Richard D.; Shillingford, Michael; Davies, Ryan R.; Koltai, Peter J.; Navaratnam, Manchula; Reddy, V. Mohan; Hanley, Frank L.

doi:10.1016/j.athoracsur.2011.12.063

Cited by 31 publications

(17 citation statements)

References 16 publications

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“…According to previous studies, the mortality of slide tracheoplasty ranged from 5% to 30%. [ 2 , 16 , 21 ] As shown in many studies, the mortality was 11%, [ 2 ] 7%, [ 7 ] 14%, [ 15 ] 5%, [ 16 ] and 11.8%. [ 17 ] Comparably, the mortality of our study was 9.9%.…”

Section: Discussionmentioning

confidence: 99%

“…[ 3 , 4 ] Tracheal stenosis is usually associated with congenital cardiovascular anomalies, which should be addressed concomitantly by surgery. [ 5 – 7 ] During the past 30 years, various surgical techniques have emerged to correct tracheal stenosis. [ 8 – 12 ] Among them, slide tracheoplasty has shown superior clinical results and been advocated as the technique of choice for most cases of tracheal stenosis.…”

Section: Introductionmentioning

confidence: 99%

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Slide tracheoplasty in 81 children

Zhang

Wang

et al. 2017

Medicine

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The aim of this study was to evaluate the surgical outcome of slide tracheoplasty.Eighty-one patients who underwent slide tracheoplasty were retrospectively reviewed. Before and after operation, all patients were examined by computed tomography (CT) and bronchoscopy regularly.There were 8 deaths and the mortality was 9.9%. They all died of respiratory failure associated with the formation of granulation tissue in the airway postoperatively. The mortality was 15.8% from 2009 to 2012 and decreased to 8.1% from 2013 to 2016. The mortality of patients aged 10 to 24 months was 5.7%, which was significantly lower than those younger than 10 months and those older than 24 months. After surgery, 11 patients had granulation tissue growing at anastomosis edges and 8 of them died eventually. Twenty patients had mucosa varus at the site of anastomosis which mainly happened in the early time. Between different time periods and different age groups, there was significant difference in the incidence of granulation tissue and mucosa varus (P < .01). Clinical symptoms of tracheal stenosis disappeared and the results of CT were satisfactory after operation.Slide tracheoplasty is an effective surgical method for congenital tracheal stenosis associated with congenital heart disease. With the continuous improvement of surgical technique, the mortality has been reduced and the incidence of granulation tissue and mucosa varus also has been reduced. The period of 10 to 24 months of age is the optimal cure time.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Slide tracheoplasty in 81 children

Zhang

Wang

et al. 2017

Medicine

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“…A paper by Mainwaring et al 1 describes the cases of 27 patients with tracheal stenosis from 2003 to 2011, 21 of whom had combined cardiac and tracheal pathology. With two postoperative deaths in children with single ventricles, the rest of the cohort did not require repeat surgery and the median duration of follow-up was 4 years.…”

Section: Discussionmentioning

confidence: 99%

The finding of an undiagnosed long segment tracheal stenosis in a cyanotic child undergoing an arterial switch operation and VSD closure

2015

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This report details the case of a 2-month-old baby boy with known cyanotic congenital heart disease (double outlet right ventricle with subpulmonary ventricular septal defect, VSD) in whom tracheal stenosis was undetected, being found later on failed intubation while undergoing anaesthesia for an arterial switch operation and VSD closure. As a result, the cardiac surgery was postponed. Such an association between congenital heart disease and tracheal stenosis has been reported but remains exceptionally rare. The baby subsequently underwent a slide tracheoplasty the next day and had major cardiac surgery a few days later. He was discharged approximately 3 weeks later after spending 8 days on the cardiac intensive care unit.

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“…Tracheal reconstruction is a primary treatment option for pediatric patients, however because of the small size of the pediatric airway, children do not experience the same success with resection and end‐to‐end anastomosis that adults can achieve . Ischemia and anastomotic tension resulting from reconstruction can cause restenosis.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of magnesium alloys for use as an intraluminal tracheal for pediatric applications in a rat tracheal bypass model

Luffy

Kumta

et al. 2018

J Biomed Mater Res

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Tracheal stenting currently using non-degradable stents is commonplace for treatment of trauma, prolonged intubation related adult airway obstructions, and pediatric patientsassociated tracheal stenosis conditions. Degradable tracheal stent placement will avoid complications of stent removal and restenosis. Widespread reports exist on degradable magnesium alloys success for orthopedic and cardiovascular applications but none to date for intra tracheal use. This research explores the use of pure Mg, AZ31, and Mg-3Y alloys for degradable tracheal stent assessment. In vitro evaluation of magnesium, prototype stents in a bioreactor simulate the airway environment and corrosion. Micro-CT imaging and biocompatibility evaluation helped assess the 24-week degradation of intraluminal alloy stents following implantation in a rat tracheal in vivo bypass model. Histological analysis indicate tissue response of the harvested stented trachea segments after each time point. Corrosion studies for each alloy indicate significant differences between the simulated and control in vitro conditions. AZ31 exhibited the lowest volume loss of 6.8% in saline, while pure Mg displayed the lowest volume loss of 4.6% in simulated airway fluid (SAF), both at 1-week time points. Significant differences in percentage of total volume lost after 6 months were determined between the alloys over time. MgY alloy displayed the slowest corrosion losing only 15.1% volume after 24 weeks of immersion. Additionally, in vitro magnesium alloy corrosion was not significantly different from the percentage of total volume lost in vivo at 1-week time point. The study demonstrates promise of magnesium alloys for intraluminal tracheal stent application albeit viability of a clinically translatable model warrants further studies.

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Surgical Reconstruction of Tracheal Stenosis in Conjunction With Congenital Heart Defects

Cited by 31 publications

References 16 publications

Slide tracheoplasty in 81 children

Slide tracheoplasty in 81 children

The finding of an undiagnosed long segment tracheal stenosis in a cyanotic child undergoing an arterial switch operation and VSD closure

Evaluation of magnesium alloys for use as an intraluminal tracheal for pediatric applications in a rat tracheal bypass model

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