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Subglottic stenosis in children undergoing repair of congenital heart defects

Emad Mossad1, George Youssef

  • 1Department of Pediatric Anesthesia, Texas Children's Hospital, Houston, TX, USA. ebmossad@texaschildrenshospital.org

Journal of Cardiothoracic and Vascular Anesthesia
|February 24, 2009
PubMed

Insights

Subglottic stenosis is an uncommon complication in pediatric patients undergoing congenital heart defect repair. Younger age and prolonged ventilation are key risk factors, but early diagnosis leads to favorable outcomes.

Area of Science:

  • Pediatric Cardiology
  • Thoracic Surgery
  • Pediatric Critical Care

Background:

  • Subglottic stenosis (SGS) is a potential complication following airway manipulation in infants and children.
  • Congenital heart disease (CHD) repair often necessitates prolonged intubation and ventilation, increasing the risk of airway injury.

Purpose of the Study:

  • To determine the incidence of subglottic stenosis in children with CHD after surgical repair.
  • To identify risk factors associated with the development of subglottic stenosis in this population.

Main Methods:

  • Retrospective chart review of pediatric patients undergoing cardiac surgical repair.
  • Analysis of patient demographics, intubation duration, and diagnosis of subglottic stenosis.

Main Results:

  • The incidence of subglottic stenosis was 2.3% in children under 1 year and 2.1% under 2 years old.
  • Prolonged intubation (>96 hours) significantly increased the risk (16%) compared to short intubation (<24 hours, 0.58%).
  • Use of cuffed endotracheal tubes did not correlate with an increased risk of subglottic stenosis.

Conclusions:

  • Subglottic stenosis is an infrequent complication in pediatric CHD surgical repair.
  • Younger age and extended postoperative ventilation are primary risk factors.
  • Prompt diagnosis and intervention are crucial for favorable patient outcomes.
Abstract

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