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Airway Abnormalities in Children Operated for Congenital Heart Disease: Clinical characteristics and risk factors

Fatma Al Kindi1,2,3, Rand Al Harthy1,2,3, Saif Awlad Thani2,4

  • 1Child Health Department, Al Nahda Hospital, Ministry of Health, Muscat, Oman.

Sultan Qaboos University Medical Journal
|October 23, 2025
PubMed

Insights

Airway abnormalities (AAs) are common in children with congenital heart disease (CHD). Prematurity is a risk factor for AAs, leading to longer ventilation times in these complex pediatric cases.

Area of Science:

  • Pediatric Cardiology
  • Thoracic Surgery
  • Congenital Abnormalities

Background:

  • Congenital heart disease (CHD) is the most frequent congenital defect.
  • Airway abnormalities (AAs) are significant comorbidities in CHD patients, increasing complexity and morbidity.

Purpose of the Study:

  • To identify common AAs in children with CHD.
  • To determine risk factors associated with AAs in this population.
  • To analyze clinical outcomes in children with CHD and concurrent AAs.

Main Methods:

  • A case-control study was conducted on children under 13 with CHD who had cardiothoracic surgery.
  • Cases had concurrent AAs; controls had CHD without AAs, matched for age and gender.
  • Data were collected between January 2016 and December 2018 at the National Genetic Centre in Oman.

Main Results:

  • The prevalence of AAs in children with CHD was 5.5%.
  • Vascular compressions (47.4%) and airway malacia (23.1%) were the most frequent AAs.
  • Prematurity was a significant risk factor (OR 3.2), and AAs were associated with longer invasive ventilation durations.

Conclusions:

  • AAs are critical comorbidities in pediatric CHD.
  • Increased clinical vigilance and early AA investigation are recommended for children with CHD.
  • Further prospective studies are needed to understand long-term implications.
Abstract

Keywords:
Airway ObstructionBronchomalaciaCongenital Heart DiseaseTracheomalaciaVascular Compression

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