Related Experiment Video
Updated: Jul 20, 2025
Transuterine Fetal Tracheal Occlusion Model in Mice
Published on: February 5, 2021
Treatment of long-segment congenital tracheal stenosis with congenital cardiovascular defects in infancy
Lurun Dai1, Lu Zhao1, Lianju Shen2
1Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, China; Ministry of Education Key Laboratory of Child Development and Disorders, China; National Clinical Research Center for Child Health and Disorders, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China; Chongqing Key Laboratory of Pediatrics, China; Children's Hospital of Chongqing Medical University, China.
Insights
Simultaneous repair of long-segment congenital tracheal stenosis (LSCTS) and congenital cardiovascular defects (CCD) in infants is safe and effective. Slide tracheoplasty offers a valid approach for LSCTS repair, minimizing restenosis and reinterventions.
Area of Science:
- Pediatric Surgery
- Cardiothoracic Surgery
- Congenital Malformations
Background:
- Long-segment congenital tracheal stenosis (LSCTS) and congenital cardiovascular defects (CCD) frequently coexist in infants.
- Managing these complex conditions simultaneously presents significant surgical challenges.
- Previous approaches often involved staged repairs, with varying outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of simultaneous surgical repair for infants diagnosed with LSCTS and CCD.
- To assess the outcomes of slide tracheoplasty combined with cardiovascular defect correction.
- To analyze complication rates, mortality, and long-term results of the combined procedure.
Main Methods:
- Retrospective review of clinical data for infants under 1 year with LSCTS and CCD undergoing simultaneous repair (January 2020 - March 2023).
- Systematic literature search of PubMed, Embase, and Cochrane Library for relevant published studies on simultaneous CTS and CCD repair in infancy.
- Meta-analysis using the inverse variance method (DerSimonian-Laird) for pooled estimates of mortality and re-interventions.
Main Results:
- Thirteen infants underwent simultaneous slide tracheoplasty and cardiovascular repair using cardiopulmonary bypass.
- Significant complications occurred in 3 patients, with one in-hospital death.
- Hospital survivors showed a significant increase in tracheal diameter (p < 0.001); pooled literature mortality was 10.9%, and airway re-interventions were 28.8%.
Conclusions:
- Simultaneous repair of LSCTS and CCD in infancy is a safe and effective treatment strategy.
- Slide tracheoplasty, with technical modifications, appears to be a valid technique for LSCTS repair in this cohort.
- The combined approach can lead to improved airway dimensions without significant long-term restenosis or need for reintervention.
Objectives:
This study aims to evaluate the outcomes of simultaneous repair for infants with long-segment congenital tracheal stenosis (LSCTS) with congenital cardiovascular defects (CCD).
Methods:
We retrospectively reviewed the clinical data of infants aged less than 1 year with LSCTS and CCD who underwent simultaneous repair at Children's Hospital of Chongqing Medical University from January 2020 to March 2023. A systematic search of PubMed, Embase, and Cochrane Library for the relevant published studies that reported the simultaneous repair of CTS and CCD in infancy was conducted in March 2023. The inverse variance method of DerSimonian-Laird (D + L) was used for estimate synthesis.
Results:
A total of thirteen infants with a mean age of 5.6 ± 3.1 months and a mean weight of 6.4 ± 0.9 Kg underwent slide tracheoplasty with modified procedures and cardiovascular operations. LSCTS was diagnosed in all thirteen patients. Nine infants were ventilator dependent, and four patients were operated on due to persistent wheezing and recurrent respiratory infections. Seven patients underwent pulmonary artery sling repair, and six underwent atrial septal defect repair. All infants were repaired utilizing cardiopulmonary bypass (CPB) support. Significant complications were recorded in three patients. In-hospital deaths were seen in one case. The median tracheal minimum diameter of hospital survivors was significantly larger than the preoperative minimum diameter (p < 0.001). The mean follow-up duration was 17.1 ± 7.1 months. There was no late mortality during the follow-up. Twelve studies were included based on our search strategy. The pooled estimate of mortality in the literature was 10.9% (95%CI, 5.3%-17.7%, I2 = 0). The pooled estimate of airway re-interventions was 28.8% (95%CI, 14.5%-43.2%, I2 = 74%).
Conclusions:
Simultaneous repair of LSCTS and CCD in infancy is safe and effective. Slide tracheoplasty with appropriate technical modifications may be valid for LSCTS repair without significant restenosis and reinterventions.
Related Concept Videos
01:22Trachea
Anatomical Features:
Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of...
01:28Tracheostomy: Procedure and Tubes
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
01:30Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
01:23Oxygen Delivering System III: Tracheostomy and T-piece
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
01:26Mitral Stenosis III: Medical Management
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...