Autopericardial patch tracheoplasty for tracheal stenosis after arterial switch operation

Though congenital tracheal stenosis in infants with congenital heart disease is uncommon, congestive heart failure is often deteriorated by respiratory symptoms. We report an infant having a diagnosis of congenital tracheal stenosis complicated with congenital heart disease who underwent pericardial patch tracheoplasty after the arterial switch operation for the transposition of the great arteries. External appearance of the trachea showed no stenosis and tracheal rings were well formed. Intraoperative bronchofiberscopy transilluminated the upper border of stenosis. The trachea was opened longitudinally to the extent of 30 mm to the point from 10 mm point proximal to the bifurcation. The incision was enlarged with the autologous pericardial patch using running absorbable suture. Then pericardial patch was anchored at several points to the posterior surface of the ascending aorta, innominate artery, and to the strap muscles of the neck. He is doing well now without any respiratory symptom.