A mediastinal window approach to aortopexy

Between 1989 and 1994 six infants underwent aortopexy for symptomatic tracheomalacia via an anterior mediastinal window. This approach avoids a thoracotomy by using a small transverse incision over the second and third intercostal spaces followed by subchondral excision of these costal cartilages to expose the mediastinum. All patients had stridor and significant respiratory difficulty preoperatively; all experienced significant improvement in symptoms after aortopexy. There were no significant complications attributable to the procedure. The authors recommend this approach for aortopexy.