Flexible fiberoptic bronchoscopy in children with heart diseases: a twelve years experience

Area of Science:

• Pediatric Cardiology
• Pulmonology
• Medical Procedures

Background:

• Cardiac and respiratory disorders in children are interconnected, necessitating integrated evaluation.
• Flexible fiberoptic bronchoscopy (FB) offers diagnostic and therapeutic benefits for airway assessment.
• Understanding the role of FB in pediatric cardiac patients is crucial.

Purpose of the Study:

• To describe the experience and outcomes of flexible fiberoptic bronchoscopy (FB) in children with congenital and acquired cardiac diseases.
• To characterize the demographic and clinical features of these patients.
• To evaluate the safety and efficacy of FB in this population.

Main Methods:

• Retrospective review of 104 FB procedures performed on 72 pediatric patients (<14 years) with heart diseases between 1993 and 2004.
• Analysis of patient demographics, cardiac diagnoses, indications for FB, and findings.
• Documentation of procedural outcomes, including complications and therapeutic utilities.

Main Results:

• Left-to-right shunt (51.9%) was the most common cardiac condition. Main indications included atelectasis (35%), stridor (14%), and pneumonia (14%).
• Airway malacias (24%), particularly left main bronchus malacia, were the most frequent findings, followed by extrinsic bronchial compression (75% affecting the left main bronchus).
• FB yielded 16 types of clinically significant interventions with no mortality and only one easily managed major complication.

Conclusions:

• Flexible fiberoptic bronchoscopy (FB) is a valuable and safe diagnostic and therapeutic tool for neonates, infants, and children with various cardiac diseases.
• FB effectively identifies and manages airway abnormalities, such as malacias and compressions, in pediatric cardiac patients.
• Integrated assessment using FB is essential for managing the complex interplay of cardiac and respiratory conditions in children.