Intermediate-term results of the free tracheal autograft for long segment congenital tracheal stenosis

Carl L. Backer, Constantine Mavroudis, Michael E. Dunham, Lauren Holinger

Research output: Contribution to journalArticle

Abstract

Background/Purpose: Since 1996 a new procedure - the free tracheal autograft - has been used to repair long segment congenital tracheal stenosis (LSCTS). The purpose of this report is to examine the intermediate-term results of that technique. Methods: Between January 1996 and July 1999, 10 infants underwent repair of LSCTS using a free tracheal autograft. Age ranged from 10 days to 23 months (mean age, 6.6 months). Six infants had a pulmonary artery (PA) sling; 5 had intracardiac anomalies. On cardiopulmonary bypass (CPB) the trachea was incised anteriorly through the area of stenosis. The midportion of the stenotic trachea was excised, and an end-to-end anastomosis was made posteriorly. The excised tracheal segment was trimmed and sutured in place anteriorly as a free autograft. In 5 patients the autograft was not long enough, and the upper portion of the tracheal opening was patched with pericardium. Results: There was 1 death 26 days postoperatively in a child that had simultaneous repair of tetralogy of Fallot and required extracorporeal membrane oxygenation postoperatively for cardiac failure. The other 9 children are alive and well at 2 to 44 months postoperatively (mean follow-up, 24 months). One child had autograft dehiscence and required replacement of the autograft with an aortic homograft. Two children have tracheostomies at 6 and 36 months postoperatively. All children have had serial postoperative bronchoscopic examinations. Most recent bronchoscopies have shown widely patent tracheal lumina in all survivors. Conclusion: Intermediate-term follow-up of children with a free tracheal autograft continues to support our use of this technique as our procedure of choice for infants with LSCTS. Copyright (C) 2000 by W.B. Saunders Company.

Original languageEnglish (US)
Pages (from-to)813-819
Number of pages7
JournalJournal of pediatric surgery
Volume35
Issue number6
DOIs
StatePublished - Jun 2000
Externally publishedYes

Keywords

  • Complete tracheal rings
  • Tracheal autograft
  • Tracheal stenosis
  • Tracheoplasty

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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