Reoperation after pericardial patch tracheoplasty.
Between 1982 and 1995, 28 infants underwent pericardial tracheoplasty for long-segment tracheal stenosis. Seven of these infants required reoperation or stenting for residual or recurrent tracheal or bronchial stenosis. Revisions were performed 2 to 6 months after the original procedure with cardiopulmonary bypass and bronchoscopic guidance. Two patients underwent repeat pericardial patch tracheoplasty, and four patients underwent insertion of a rib cartilage graft. Two of these patients required Palmaz wire expandable stents and one other patient also underwent stent placement. There was one late death 1 year after cartilage graft insertion. The authors identified three risk factors for reoperation after tracheoplasty; younger age at initial surgery and associated pulmonary artery sling or tracheal right upper lobe bronchus. Good intermediate results are possible in this difficult group of children using a selective and inclusive strategy for tracheal enlargement that includes repeat pericardial tracheoplasty, autologous cartilage grafts, and expandable wire stents.
Backer
C L
CL
Children's Memorial Hospital, and the Department of Surgery, Northwestern University Medical School, Chicago, IL 60614, USA.
Mavroudis
C
C
Dunham
M E
ME
Holinger
L D
LD
D000367:Age Factors; D002356:Cartilage / Q000637:transplantation; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010496:Pericardium / Q000637:transplantation*; D011651:Pulmonary Artery / Q000002:abnormalities; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D015607:Stents; D014135:Tracheal Stenosis / Q000151:congenital* / Q000473:pathology / Q000601:surgery*