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Anterior and posterior tracheopexy for severe tracheomalacia

Thomas Martens1, Heidi Schaballie2, Julie Willekens2

  • 1Department of Cardiac Surgery, Ghent University Hospital, Ghent, Belgium.

JTCVS Techniques
|February 23, 2023
PubMed

Insights

This study shows that a combined posterior and anterior pexy surgery is a feasible treatment for congenital tracheomalacia in children, yielding good short- and midterm results.

Area of Science:

  • Pediatric Surgery
  • Thoracic Surgery
  • Respiratory Medicine

Background:

  • Congenital tracheomalacia is a significant cause of respiratory failure in infants and young children.
  • Current surgical treatment guidelines for tracheomalacia are not well-established, leading to varied approaches.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of a specific surgical technique for congenital tracheomalacia.
  • To assess the short- and midterm results of combined posterior and anterior pexy for severe tracheomalacia.

Main Methods:

  • A sternotomy approach was used to perform combined posterior pexy and anterior tracheopexy.
  • A tailored ringed polytetrafluoroethylene (PTFE) prosthesis was utilized in the procedure.
  • Analysis included patient demographics, operative details, and postoperative outcomes.

Main Results:

  • Nine children with severe, bronchoscopically confirmed tracheomalacia underwent the procedure between 2018 and 2022.
  • No operative mortality was observed; 8 out of 9 patients were successfully weaned from mechanical ventilation.
  • Excellent clinical results with no reinterventions were noted during a follow-up period of up to 4 years.

Conclusions:

  • Combined posterior and anterior pexy is a viable surgical option for congenital tracheomalacia.
  • This surgical approach demonstrates acceptable short- and midterm efficacy in pediatric patients.
  • The technique offers promising results for managing severe cases of tracheomalacia.
Abstract

Keywords:
CT, computed tomographyPICU, pediatric intensive care unitPTFE, polytetrafluoroethyleneTM, tracheomalaciaairway surgerypediatrictracheomalacia

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