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Treatment of tracheal stenosis with extracorporeal membrane oxygenation support in infants and newborns
Author(s) -
Pola dos Reis Flavio,
Minamoto Helio,
Bibas Benoit Jacques,
Minamoto Fabio Eiti Nishibe,
Cardoso Paulo Francisco Guerreiro,
Caneo Luiz Fernando,
PêgoFernandes Paulo Manuel
Publication year - 2021
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.13898
Subject(s) - medicine , extracorporeal membrane oxygenation , stenosis , tracheal stenosis , surgery , retrospective cohort study , heart disease , cardiac surgery , subglottic stenosis , cardiology
Abstract Tracheal stenosis in children is a challenge for the healthcare team, since it is a rare disease. Patients usually have other clinical comorbidities, mainly previous cardiac surgical interventions. This retrospective single‐center study included infants with tracheal stenosis (congenital or acquired) operated between 2016 and 2020 on venoarterial extracorporeal membrane oxygenation (VA ECMO). Five patients were operated and the median age of detection of the tracheal disease was 3.7 months, and the median age at the operation was 5 months. All patients had associated cardiac anomalies. Four patients had congenital tracheal stenosis; two with associated pig bronchus. One patient had acquired subglottic stenosis with concomitant stenosis at the carina. After the operation, the patients were referred to ICU on ECMO with an open chest. Minor ECMO‐related complications occurred in two patients (hemothorax and wound infection). All patients required endoscopic evaluation during the postoperative care; median of 3.2 procedures. Two patients are currently in follow‐up and three have died. Slide tracheoplasty with VA‐ECMO can be successfully performed in infants with prior cardiac surgery. Nevertheless, a difficult postoperative course should be anticipated, with possible prolonged ECMO use, readmissions, and higher morbidity and mortality than in children with tracheal stenosis alone.