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

Published online by Cambridge University Press:  20 November 2019

Colin J. McMahon Open the ORCID record for Colin J. McMahon [Opens in a new window] ,
Karim Ayoubi ,
Rania Mehanna ,
Eithne Phelan ,
Eoin O’Cearbhaill Open the ORCID record for Eoin O’Cearbhaill [Opens in a new window] ,
John Russell  and
Lars Nölke
Colin J. McMahon*
Affiliation:
Department of Paediatric Cardiology, Our Lady’s Hospital for Sick Children, Crumlin, Dublin, Ireland School of Medicine, University College Dublin, Belfield, Dublin, Ireland
Karim Ayoubi
Affiliation:
Department of Cardiothoracic Surgery, Our Lady’s Hospital for Sick Children, Crumlin, Dublin, Ireland
Rania Mehanna
Affiliation:
Department of Otolaryngology, Our Lady’s Hospital for Sick Children, Crumlin, Dublin, Ireland
Eithne Phelan
Affiliation:
Department of Radiology, Our Lady’s Hospital for Sick Children, Crumlin, Dublin, Ireland
Eoin O’Cearbhaill
Affiliation:
UCD Centre for Biomedical Engineering and School of Mechanical & Materials Engineering, University College Dublin, Belfield, Dublin, Ireland
John Russell
Affiliation:
Department of Otolaryngology, Our Lady’s Hospital for Sick Children, Crumlin, Dublin, Ireland
Lars Nölke
Affiliation:
Department of Cardiothoracic Surgery, Our Lady’s Hospital for Sick Children, Crumlin, Dublin, Ireland
*
Author for correspondence: Prof. C. J. McMahon, Department of Paediatric Cardiology, Our Lady’s Children’s Hospital, Crumlin, Dublin 12, Ireland. Tel: 01-4282854; E-mail: [email protected]
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Abstract

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.

Keywords

Tracheal stenosiscongenitalheart defectslide tracheoplastysurgery3D printing
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 1 , January 2020 , pp. 34 - 38
Copyright
© Cambridge University Press 2019

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