Related Experiment Video
Updated: Mar 17, 2026

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
Published on: August 26, 2025
A New Treatment Paradigm for Tetralogy of Fallot/Absent Pulmonary Valve with Significant Airway Compromise:
Richard G Ohye1, John D Vossler2, Glenn E Green3
1Section of Pediatric Cardiovascular Surgery, Department of Cardiac Surgery, University of Michigan Medical School, Ann Arbor, Michigan.
Purpose:
Tetralogy of Fallot with absent pulmonary valve (TOF-APV) can manifest neonatally with severe respiratory insufficiency secondary to tracheobronchomalacia (TBM). Typical treatment of patients with TOF-APV with significant respiratory compromise is directed at the underlying heart defect rather than the airway. Complete repair often does not ameliorate airway issues and subsequently requires a tracheostomy or ventilator.
Description:
Given this lack of effective treatment, a bioresorbable, patient-specific, 3-dimensionally printed splint was developed that provides external support to the airways.
Evaluation:
Eight patients with TOF-APV and TBM underwent airway splinting. Cohort 1 underwent splinting after (n = 5) or concurrently with (n = 1) a complete repair with a right ventricle-to-pulmonary artery conduit. Cohort 2 underwent splinting before a complete repair (n = 2). All cohort 1 patients required tracheostomy and long-term ventilator support. The cohort 2 patients were discharged home after splinting and returned to undergo elective tetralogy of Fallot (TOF) repair without a conduit.
Conclusions:
Patients with TOF-APV and airway compromise may avoid early repair with a conduit and tracheostomy with initial airway splinting. They are then able to undergo elective TOF repair without a conduit.
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