Surgical management of tracheal stenosis in an infant with multiple congenital anomalies: when is baby inoperable?
Congenital tracheal stenosis is a rare disorder that carries a significant morbidity and mortality. It is an even greater challenge when present in combination with other life-threatening congenital anomalies. We present an infant with multiple congenital anomalies, including trisomy 21, who was diagnosed with congenital tracheal stenosis at 3 months of age. At age 5 months, the infant underwent tracheoplasty with costal cartilage graft and pulmonary artery banding. Bronchoscopy 3 weeks later revealed a patent airway. However, the patient died 2 months postoperatively of cardiac complications. At autopsy, whole organ and histologic specimens revealed excellent incorporation of the graft with no evidence of re-stenosis. Our documentation of graft incorporation in this patient is evidence that long segments of stenotic trachea can be successfully treated by tracheoplasty utilizing rib cartilage grafts.
Mambrino
L J
LJ
Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.
Kenna
M A
MA
Seashore
J
J
D000015:Abnormalities, Multiple / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D014135:Tracheal Stenosis / Q000151:congenital / Q000601:surgery*