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Tetralogy of Fallot and subglottic stenosis surgery with holmium laser in the same session
Mustafa Okumuş1, Özgür Yıldırım2, Hakan Kilercik3
1Faculty of Medicine, Department of Pediatric Surgery, Gaziosmanpaşa Hospital and Bahat Hospital, Yeni Yüzyıl University, Merkez Mahallesi, Çukurçeşme caddesi, No: 51, Gaziosmanpaşa, 34245, Istanbul, Turkey. drmustafaokumus@gmail.com.
Insights
Pediatric subglottic stenosis, a rare complication of cardiac surgery, can be safely treated with a holmium laser during cardiopulmonary bypass. This combined approach offers a successful solution for complex congenital heart disease patients.
Area of Science:
- Cardiology
- Otolaryngology
- Pediatric Surgery
Background:
- Subglottic stenosis occurs in 0.57-2.3% of pediatric cardiac surgery patients.
- An 11-year-old female with a history of modified Blalock-Taussig shunt presented for tetralogy of Fallot repair.
- Preoperative evaluation revealed subglottic stenosis.
Observation:
- The patient underwent total repair of tetralogy of Fallot under cardiopulmonary bypass.
- Subglottic stenosis was simultaneously addressed using a holmium laser.
- The endoscopic laryngeal procedure was performed while the patient was on cardiopulmonary bypass.
Findings:
- Holmium laser treatment of subglottic stenosis was successful.
- The combined cardiac and laryngeal surgery was performed without complications.
- This demonstrates the feasibility of concurrent procedures.
Implications:
- Cardiac and endoscopic laryngeal surgeries can be safely combined in select pediatric patients.
- Holmium laser is an effective tool for treating subglottic stenosis during cardiopulmonary bypass.
- This approach may improve outcomes for complex pediatric cardiac cases with airway compromise.
Abstract:
The incidence of subglottic stenosis after pediatric cardiac surgery is around 0.57-2.3%. An 11-year-old female patient, who underwent modified Blalock-Taussig shunt surgery at the age of 4 months, was interned for total repair of tetralogy of Fallot. Subglottic stenosis was revealed in preoperative examination with indirect laryngoscopy. Total repair of tetralogy of Fallot was performed under cardiopulmonary bypass support. While the patient was still on cardiopulmonary bypass support, subglottic stenosis was treated by holmium laser successfully without a complication. In suitable patients, cardiac and endoscopic laryngeal operations can be successfully and safely performed under cardiopulmonary bypass with a holmium laser.
