Original articleGeneral thoracicSlide Tracheoplasty in Infants and Children: Risk Factors for Prolonged Postoperative Ventilatory Support
Section snippets
Patients and Methods
Forty infants and children underwent slide tracheoplasty at Cincinnati Children’s Hospital Medical Center from April 2001 through March 2006. Twenty boys and 20 girls underwent operation at a median age of 6.2 months (range, 7 days to 15 years) and a median weight of 6.1 kg (range, 1.9 to 57 kg). Age distribution is shown in Figure 1. Patient characteristics, hospital course, and outcomes were reviewed. Institutional Review Board approval with waiver for the need to obtain individual consent
Results
Twenty patients had associated cardiovascular anomalies, of which left pulmonary artery (LPA) sling was the most common (11). Six patients had ventricular septal defects (1 with left pulmonary artery sling also and another with pulmonary vein stenosis also). There were 3 cases of tetralogy of Fallot or double-outlet right ventricle with tetralogy physiology, 1 common atrium, and 1 LSVC to the left atrium without intra-atrial communication. Thirteen patients had undergone prior operations
Comment
Congenital long-segment tracheal stenosis is a challenging problem. Although it may become symptomatic across a variety of ages, the most common presentation is in the first months of life. We have often been surprised how well some of these infants may appear clinically at the time of initial diagnosis despite the severity of luminal narrowing of the trachea. In fact, quite a number of patients escaped recognition until they were found either to have difficulty with intubation for a nonairway
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