Management of tracheomalacia in an infant with Tetralogy of Fallot

Area of Science:

• Pediatric Surgery
• Cardiology
• Respiratory Medicine

Background:

• Tracheomalacia, a condition of the windpipe, often resolves spontaneously in infants.
• Severe cases with recurrent respiratory infections necessitate active treatment, including chest physiotherapy, intubation, or tracheostomy.
• Aortopexy is emerging as a primary treatment for severe tracheomalacia.

Purpose of the Study:

• To evaluate the efficacy of aortopexy in treating severe tracheomalacia in an infant with congenital heart disease.
• To present a case study of successful surgical intervention for ventilator-dependent tracheomalacia.

Main Methods:

• A 3-month-old infant with severe tracheomalacia and cyanotic congenital heart disease underwent intracardiac repair and aortopexy with Lecompte's procedure.
• The surgical technique involved suturing the anterior aortic wall to the sternum to prevent tracheal collapse.

Main Results:

• The infant, previously on ventilatory support for two months, was successfully extubated on the third postoperative day.
• The postoperative period was uneventful, indicating successful management of severe tracheomalacia and congenital heart disease.

Conclusions:

• Aortopexy, combined with intracardiac repair and Lecompte's procedure, is a viable and effective treatment for severe, ventilator-dependent tracheomalacia in infants with complex congenital heart disease.
• This surgical approach offers a promising solution when conservative measures fail.