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A modified surgical technique for aortopexy in tracheobronchomalacia
Onur B Dolmaci1,2, Marc Matthijs Fockens3, Matthijs W Oomen4
1Department of Cardiothoracic Surgery, Amsterdam University Medical Center location AMC, Amsterdam, Netherlands.
Interactive Cardiovascular and Thoracic Surgery
|May 8, 2021
Summary
Modified aortopexy using aortic wall strap sutures effectively treats severe tracheobronchomalacia (TBM), improving respiratory symptoms in most patients. This surgical technique appears safe and beneficial for TBM management.
Area of Science:
- Thoracic surgery
- Pediatric surgery
- Respiratory medicine
Background:
- Tracheobronchomalacia (TBM) involves trachea and bronchus collapse, causing respiratory distress.
- Severe TBM often requires surgical intervention, with aortopexy being a common procedure.
- Existing aortopexy techniques may have limitations in distributing traction force.
Purpose of the Study:
- To evaluate the outcomes of a modified anterior aortopexy technique using aortic wall strap sutures for TBM.
- To assess the efficacy and safety of this novel surgical approach.
Main Methods:
- Retrospective chart review of patients who underwent modified aortopexy for TBM.
- Study conducted across two tertiary hospitals in the Netherlands from January 2010 to June 2020.
- Modified technique involves aortic wall strap sutures for even traction distribution.
Main Results:
- Twenty-four patients (median age 9 months) with TBM, tracheomalacia, or bronchomalacia were included.
- The modified aortopexy achieved a 91.7% success rate, defined by symptom improvement and reduced respiratory support needs.
- Complications were observed in 8.3% of patients, with a 4% mortality rate.
Conclusions:
- Modified aortopexy with aortic wall strap sutures demonstrates effectiveness and safety in treating severe TBM.
- The technique provides solid and reliable traction, suggesting potential advantages over conventional methods.
- Further comparative studies are recommended to confirm the benefits of strap sutures in aortopexy.
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