title: One-stage surgical correction of congenital tracheal stenosis complicated with congenital heart disease in infants and young children.
abstract: OBJECTIVE
  Although the outcome of surgical treatment of congenital tracheal stenosis (CTS) has improved, surgical intervention for these patients, especially for those with associated congenital heart disease (CHD) remains challenging. In this report, we summarized our experience with these defects.
  
  
  METHODS
  Clinical data were collected for children undergoing tracheoplasty and CHD surgery from January 2001 to March 2013. Bivariate and multiple regression analyses were used to determine the correlation between the variables.
  
  
  RESULTS
  Forty-three patients underwent simultaneous repair of CTS and CHD. Their ages ranged from two months to nine years (mean 23.16 months) and weights from 3.5 to 46.1 kg (mean 10.71 kg). Associated CHD included pulmonary artery sling (n = 31), tetralogy of Fallot (n = 5), ventricular septal defect (n = 4), atrial septal defect (n = 4), double aortic arch (n = 2), and pulmonary atresia with ventricular septal defect (n = 1). Five patients underwent simple tracheal resection, eight patients underwent tracheal autograft, and 30 patients received slide tracheoplasty. There were seven deaths, five early and two late; the most common cause was the growth of granulation tissue. In bivariate analysis, the length of tracheal stenosis (p < 0.01), age (p < 0.01), and complications (p < 0.01) were associated with mortality. Shorter duration of postoperative mechanical ventilation (p < 0.05) and less serious complications (p < 0.05) were associated with slide tracheoplasty. The percentage of slide tracheoplasty was higher in long-segmental and diffuse tracheal stenosis (p < 0.01).
  
  
  CONCLUSIONS
  Slide tracheoplasty is the best option for surgical treatment of long-segmental and diffuse tracheal stenosis. Simultaneous repair of associated CHD did not increase the complication rate and is the procedure of choice for patients with combined CTS and CHD.
authors.affiliation: Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai, China; Department of Cardiac Surgery, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: BangDe
authors.initials: B
authors.lastname: Xue
authors.forename: BeiBei
authors.initials: B
authors.lastname: Liang
authors.forename: Shunmin
authors.initials: S
authors.lastname: Wang
authors.forename: LiMin
authors.initials: L
authors.lastname: Zhu
authors.forename: ZhaoHui
authors.initials: Z
authors.lastname: Lu
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Xu
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D003952:Diagnostic Imaging; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000379:methods*; D012044:Regression Analysis; D013997:Time Factors; D014132:Trachea / Q000601:surgery*; D014135:Tracheal Stenosis / Q000151:congenital* / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D015300:Ventilator Weaning / Q000706:statistics & numerical data