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Aortopexy for the management of paediatric tracheomalacia – the Alder Hey experience

Published online by Cambridge University Press:  23 January 2020

S P Williams ,
P D Losty ,
R Dhannapuneni ,
A Lotto ,
R Guerrero  and
A J Donne
S P Williams*
Affiliation:
Department of Paediatric ENT, Alder Hey Children's Hospital, Liverpool, UK
P D Losty
Affiliation:
Department of Paediatric Surgery, Alder Hey Children's Hospital, Liverpool, UK
R Dhannapuneni
Affiliation:
Department of Paediatric Cardiothoracic Surgery, Alder Hey Children's Hospital, Liverpool, UK
A Lotto
Affiliation:
Department of Paediatric Cardiothoracic Surgery, Alder Hey Children's Hospital, Liverpool, UK
R Guerrero
Affiliation:
Department of Paediatric Cardiothoracic Surgery, Alder Hey Children's Hospital, Liverpool, UK
A J Donne
Affiliation:
Department of Paediatric ENT, Alder Hey Children's Hospital, Liverpool, UK
*
Author for correspondence: Mr Stephen P Williams, Department of Paediatric ENT, Liverpool, L14 5AB, UK E-mail: spwilliams@doctors.org.uk
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Abstract

Background

Whilst aortopexy is an accepted and established procedure, there remains considerable heterogeneity within the literature, with inconsistencies in both the approach taken and the technique employed. Furthermore, limited data exist on both patient selection and long-term outcomes. This study aimed to report the experience of managing severe tracheomalacia by way of aortopexy in a large UK paediatric centre.

Method

A retrospective case note review was conducted. Mean follow up was five years.

Results

Twenty-five patients underwent aortopexy for severe tracheomalacia caused by external vascular compression. Acute life-threatening events precipitated investigation in 72 per cent of cases. Twenty-one patients initially presented to ENT services for investigation, which comprised upper airway endoscopy and imaging with computed tomography angiography. Post-operatively, the majority of patients demonstrated complete resolution of symptoms and were discharged from all associated services. Only four patients required a tracheostomy.

Conclusion

Aortopexy offers an effective method of treating severe tracheomalacia due to vascular compression.

Keywords

TracheomalaciaTracheaBrachiocephalic TrunkVascular Ring
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 2 , February 2020 , pp. 174 - 177
Copyright
Copyright © JLO (1984) Limited, 2020

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Footnotes

Mr S P Williams takes responsibility for the integrity of the content of the paper

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