title: Surgical reconstruction of tracheal stenosis in conjunction with congenital heart defects.
abstract: BACKGROUND
  Surgical reconstruction is the primary method of treating airway obstruction in children. Tracheal stenosis is frequently associated with congenital heart defects, which may further complicate the overall management strategy. The purpose of this study was to review our experience with surgical reconstruction of airway obstruction in conjunction with congenital heart defects.
  
  
  METHODS
  This was a retrospective review of our surgical experience with tracheal stenosis from February 2003 to August 2011. Twenty-seven patients were identified in our database. Six patients had isolated, congenital tracheal stenosis, and 21 had tracheal stenosis in association with congenital heart defects. There were two identifiable subgroups. Thirteen patients had airway stenoses identified concurrently with congenital heart defects and underwent combined repair. The second group comprised 8 patients who had previous correction of their congenital heart defects and experienced delayed presentation of tracheal (n = 6) or bronchial (n = 2) obstruction.
  
  
  RESULTS
  The median age at surgery was 9 months. There were 2 postoperative deaths, both in children with single ventricle. The median duration of follow-up for the entire cohort of 25 surviving patients was 4 years. None of the patients have required reoperations on the trachea; 5 have had minor reinterventions.
  
  
  CONCLUSIONS
  The data demonstrate that tracheal obstruction is frequently found in conjunction with congenital heart defects. Nearly one third of our patients had delayed presentation of airway obstruction that was identified subsequent to previous congenital heart defect repair. Tracheal reconstructive techniques were effective regardless of the cause of the airway obstruction.
authors.affiliation: Division of Pediatric Cardiac Surgery, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, California 94305, USA. mainwaring@stanford.edu
authors.forename: Richard D
authors.initials: RD
authors.lastname: Mainwaring
authors.forename: Michael
authors.initials: M
authors.lastname: Shillingford
authors.forename: Ryan
authors.initials: R
authors.lastname: Davies
authors.forename: Peter
authors.initials: P
authors.lastname: Koltai
authors.forename: Manchula
authors.initials: M
authors.lastname: Navaratnam
authors.forename: V Mohan
authors.initials: VM
authors.lastname: Reddy
authors.forename: Frank L
authors.initials: FL
authors.lastname: Hanley
mesh_terms: D000402:Airway Obstruction / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D014132:Trachea / Q000601:surgery; D014135:Tracheal Stenosis / Q000150:complications / Q000151:congenital / Q000601:surgery*