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Aortopexy in severe tracheal instability: short-term and long-term outcome in 29 infants and children

J F Vazquez-Jimenez1, J S Sachweh, O J Liakopoulos

  • 1Department of Thoracic and Cardiovascular Surgery, University Hospital RWTH Aachen, Germany. jvazquez-jimenez@post.klinikum.rwth-aachen.de

The Annals of Thoracic Surgery
|January 16, 2002
PubMed

Insights

Aortopexy effectively treats life-threatening apneas caused by tracheal instability after esophageal atresia surgery. While safe with no mortality, it does not prevent increased respiratory infections long-term.

Area of Science:

  • Pediatric Surgery
  • Thoracic Surgery
  • Critical Care Medicine

Background:

  • Tracheal instability is a significant risk following esophageal atresia repair.
  • Life-threatening apneas can occur due to flaccid trachea or external vascular compression.
  • Aortopexy is a surgical intervention considered for these severe cases.

Purpose of the Study:

  • To retrospectively analyze the efficacy and outcomes of aortopexy.
  • To evaluate both short-term and long-term results of the procedure.
  • To assess the safety profile of aortopexy in pediatric patients.

Main Methods:

  • A retrospective review of 29 patients operated on between 1985 and 2000.
  • Patients presented with life-threatening apneas secondary to tracheal instability or vascular compression.
  • The surgical technique involved ventropexy of the aortic arch to the sternum and ventral thoracic wall.

Main Results:

  • No early or late mortality was observed in the study cohort.
  • A significant improvement or resolution of apneic symptoms occurred within days to 3 months post-surgery.
  • Complications included reversible phrenic nerve lesions (2), pneumothorax (3), and wound healing issues (1).

Conclusions:

  • Aortopexy is a safe procedure with no associated mortality and low morbidity.
  • The surgery is highly effective in preventing recurrent life-threatening apneas.
  • Long-term follow-up indicated an increased susceptibility to respiratory infections despite successful apnea management.
Abstract

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