title: Pexis of the great vessels for patients with tracheobronchomalacia in infancy.
abstract: OBJECTIVE
  Aortopexy has been established as a surgical treatment for tracheobronchomalacia in infancy. However, the effects in patients with bronchial involvement remain controversial. The authors performed aortopexy and pexis of the pulmonary artery trunk (PApexy) for patients with tracheobronchomalacia.
  
  
  METHODS
  Between 1992 and 1997, 14 infants with tracheobronchomalacia were treated. Patients ranged in age from 4 months to 7 years (median, 3.5 years). Using patients' records, intraoperative bronchofiberscopic results and clinical outcomes were analyzed retrospectively.
  
  
  RESULTS
  Concerning tracheomalacia, aortopexy eliminated airway collapse as shown by intraoperative fiberscopic results and clinical outcome in 4 patients. Regarding tracheobronchomalacia, aortopexy eliminated collapse of the trachea and the right main bronchus in 3 patients but did not improve collapse of the lower half of the left main bronchus in 3 patients, which was eliminated by PApexy. Aortopexy eliminated airway collapse of the left main bronchus in 1 of 3 patients with bronchomalacia. PApexy eliminated collapse of the lower half of the left main bronchus in 1 patient.
  
  
  CONCLUSIONS
  These results indicate that intraoperative bronchofiberscopic results were closely correlated to the clinical outcome, and suggest that aortopexy is helpful for eliminating collapse of the right main bronchus and the proximal half of the left main bronchus and that PApexy eliminates collapse of the distal half of the left main bronchus.
authors.affiliation: Department of Pediatric Surgery, Osaka University Medical School, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kamata
authors.forename: N
authors.initials: N
authors.lastname: Usui
authors.forename: T
authors.initials: T
authors.lastname: Sawai
authors.forename: K
authors.initials: K
authors.lastname: Nose
authors.forename: Y
authors.initials: Y
authors.lastname: Kitayama
authors.forename: H
authors.initials: H
authors.lastname: Okuyama
authors.forename: A
authors.initials: A
authors.lastname: Okada
mesh_terms: D000015:Abnormalities, Multiple; D001011:Aorta / Q000601:surgery*; D001980:Bronchi / Q000002:abnormalities; D001982:Bronchial Diseases / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011651:Pulmonary Artery / Q000601:surgery*; D012189:Retrospective Studies; D014132:Trachea / Q000002:abnormalities; D014133:Tracheal Diseases / Q000601:surgery*