Open AccessAortopexy for Vascular Tracheal Compression in Children
Author(s) -
Wine Todd M.,
Colman Kathryn L.,
Mehta Deepak K.,
Maguire Raymond C.,
Morell Victor O.,
Simons Jeffrey P.
Publication year - 2012
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599812451438a191
Subject(s) - medicine , tracheal stenosis , airway , airway obstruction , bronchoscopy , surgery , airway management , laryngomalacia , tracheobronchomalacia , tracheomalacia , retrospective cohort study , radiology , anesthesia , stridor
Objective 1) Evaluate the presentation, diagnostic workup, and outcomes of contemporary surgical intervention for airway obstruction from innominate artery tracheal compression in children. 2) Assess the significance of synchronous airway lesions in the treatment of innominate artery tracheal compression. Method This study is a retrospective medical record review of 26 consecutive children who underwent aortopexy for innominate artery tracheal compression at a tertiary‐care children’s hospital. Presenting symptoms, diagnostic workup, presence of synchronous airway lesions, length of hospitalization, and treatment outcomes were examined. Results Twenty‐six patients (17 male, 65%) were included in the study. All were diagnosed with bronchoscopy and confirmed with radiographic imaging. Median age at diagnosis and surgery was 9.7 and 10.1 months, respectively. Presenting symptoms included noisy breathing (93%), cough (78%), dyspnea (44%), apnea (44%), cyanosis (19%), and recurrent respiratory infections (15%). Average degree of tracheal compression was 71% (SD 12%). Fifteen of 26 (58%) patients had synchronous airway lesions, including mild laryngomalacia and subglottic stenosis. Median length of stay was 2 days. Median follow‐up was 10 months. Subjective improvement occurred in all 20 patients for whom follow‐up information was available. Conclusion Anterior tracheal vascular compression can cause a variety of airway symptoms. Mild synchronous airway lesions are common and do not prevent successful aortopexy. Aortopexy is a safe and effective treatment for symptomatic anterior tracheal vascular compression from the innominate artery.