title: Simultaneous management of congenital tracheal stenosis and cardiac anomalies in infants.
abstract: OBJECTIVE
  The present article aims to describe our experience with patients who underwent simultaneous repair of congenital tracheal stenosis and cardiac anomalies.
  
  
  METHODS
  Between January 2000 and December 2003, 9 infants underwent simultaneous surgical repair of a congenital tracheal stenosis and congenital heart disease. The intraoperative findings revealed localized tracheal stenosis in 3 patients. The funnel-type tracheal stenosis was present in 6 patients. Associated cardiac anomalies included ostium secundum atrial septal defect in 5 patients and ventricular septal defect in 2 patients, pulmonary artery sling in 4 patients, patent ductus arteriosus in 6 patients, atrioventricular septal defect in 1 patient, aortic arch hypoplasia in 1 patient, coarctation of the aorta in 1 patient, and partial anomalous pulmonary venous connection in 2 patients, one of them with "scimitar syndrome." Tracheal origin of the right upper lobe was diagnosed in 2 of the patients. A right aberrant subclavian artery (lusoria) was found in one patient. All patients were operated on through a median sternotomy and with cardiopulmonary bypass. Tracheal resection with direct end-to-end anastomosis was performed in all cases.
  
  
  RESULTS
  There was no operative mortality. One patient died 6 weeks postoperatively. Eight patients were extubated between the 14th and 30th postoperative days under bronchoscopic monitoring. The extubation was performed after a stepwise respirator-weaning program. Postoperative endoscopic examination showed adequate airway dimensions and patency in every case. The midterm results after a mean follow-up of 37 months (range, 16-58 months) of the entire group demonstrate a stabile and complication-free clinical outcome.
  
  
  CONCLUSIONS
  We advocate our current strategy for infants with congenital tracheal stenosis: resection with end-to-end anastomosis and simultaneous repair of associated intracardiac anomalies.
authors.affiliation: Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany. tsloukanov@abv.bg
authors.forename: Tsvetomir
authors.initials: T
authors.lastname: Loukanov
authors.forename: Christian
authors.initials: C
authors.lastname: Sebening
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Springer
authors.forename: Herbert
authors.initials: H
authors.lastname: Ulmer
authors.forename: Siegfried
authors.initials: S
authors.lastname: Hagl
mesh_terms: D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D019616:Thoracic Surgical Procedures / Q000379:methods; D014135:Tracheal Stenosis / Q000150:complications / Q000151:congenital* / Q000601:surgery*