Anterior pericardial tracheoplasty for congenital tracheal stenosis

D. A. Heimansohn, Kenneth Kesler, Mark Turrentine, Y. Mahomed, L. Means, Bruce Matt, E. Weisberger, John Brown

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Congenital tracheal stenosis may be a life-threatening anomaly not relieved by airway intubation. Over the past 7 years, anterior pericardial tracheoplasty has been used at our institution for treatment of congenital long-segment tracheal stenosis in infants with impending airway obstruction. Case histories of eight patients undergoing nine anterior pericardial tracheoplasties have been reviewed to assess this technique. Of these patients, six have required preoperative tracheal intubation before repair to maintain ventilation. The surgical technique of anterior pericardial tracheoplasty includes a median sternotomy approach with partial normothermic cardiopulmonary bypass. An anterior tracheotomy through all hypoplastic rings allows enlargement with autologous pericardium to 1.5 times the predicted normal diameter. After insertion, the pericardium and hypoplastic tracheal cartilages are suspended to surrounding mediastinal structures, which prevents airway collapse. Seven of eight infants have survived without tracheoplasty dehiscence or wound infections. Five were ultimately extubated and are currently free of symptoms from 6 months to 5 years after anterior pericardial tracheoplasty. The other two survivors had residual stenosis as a result of complications of prior tracheostomy. One of these patients has undergone a successful second anterior pericardial tracheoplasty and is currently extubated and well. The other is palliated at 6 months with a tracheostomy awaiting a second anterior pericardial tracheoplasty. Our review of anterior pericardial tracheoplasty has demonstrated the safety, utility, and at least medium-term benefit of this procedure in infants of any age and weight.

Original languageEnglish
Pages (from-to)710-716
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume102
Issue number5
StatePublished - 1991
Externally publishedYes

Fingerprint

Tracheostomy
Pericardium
Intubation
Tracheal Stenosis
Tracheotomy
Sternotomy
Wound Infection
Airway Obstruction
Cardiopulmonary Bypass
Cartilage
Ventilation
Survivors
Pathologic Constriction
Safety
Weights and Measures
Tracheal agenesis
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Anterior pericardial tracheoplasty for congenital tracheal stenosis. / Heimansohn, D. A.; Kesler, Kenneth; Turrentine, Mark; Mahomed, Y.; Means, L.; Matt, Bruce; Weisberger, E.; Brown, John.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 102, No. 5, 1991, p. 710-716.

Research output: Contribution to journalArticle

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AU - Weisberger, E.

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