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Distal tracheal stenosis in two children with double aortic arch and associated tracheomalacia
1Department of Cardiac Surgery, Royal Hospital for Sick Children, Yorkhill, Glasgow, UK.
Insights
Persistent tracheomalacia causes significant respiratory distress in children, even after surgery for double aortic arch. Cardiopulmonary bypass may be beneficial for treating the distal trachea in these pediatric cases.
Area of Science:
- Pediatric Surgery
- Cardiology
- Respiratory Medicine
Background:
- Double aortic arch is a congenital vascular anomaly that can cause tracheomalacia and respiratory distress in infants and children.
- Vascular decompression is a common surgical approach for double aortic arch, but may not always resolve tracheomalacia.
Purpose of the Study:
- To present two case reports of children with persistent tracheomalacia and respiratory distress after vascular decompression for double aortic arch.
- To highlight the potential utility of cardiopulmonary bypass in managing distal tracheal issues in this patient population.
Main Methods:
- Case report review of two pediatric patients with double aortic arch and persistent tracheomalacia.
- Surgical intervention involving vascular decompression and, in one case, cardiopulmonary bypass for distal tracheal access.
Main Results:
- Both patients experienced significant respiratory distress due to persistent tracheomalacia despite initial surgical correction of the vascular anomaly.
- Cardiopulmonary bypass provided access to the distal trachea, suggesting its potential efficacy in managing complex tracheomalacia.
Conclusions:
- Persistent tracheomalacia can be a challenging complication following surgical repair of double aortic arch in children.
- Cardiopulmonary bypass represents a viable and potentially effective strategy for addressing the distal tracheal segment in pediatric patients with refractory tracheomalacia.
Abstract:
Two case reports are presented in children who developed significant respiratory distress due to persistent tracheomalacia despite vascular decompression for double aortic arch. Cardiopulmonary bypass is suggested as a useful approach to the distal tracheal segment in children.