AI Article Synopsis
- Congenital tracheal stenosis (CTS) is a rare and serious condition in children, particularly when complicated by a pulmonary artery sling (PA sling), and this study aims to identify when surgery is necessary for these cases.
- Researchers evaluated 42 patients treated at their hospital from 2005 to 2018, determining surgical indications based on various factors, including the ratio of tracheal diameter to stenotic length (DLR).
- The study found that a DLR value below 5.9 could be a useful indicator for deciding on surgical intervention in children with CTS complicated by PA sling, showing promising sensitivity and specificity.
Article Abstract
Background: Congenital tracheal stenosis (CTS) is a rare and life-threatening disease in children. Although pulmonary artery sling (PA sling) complicated by CTS sometimes occurs, there are few reports detailing the management of CTS with PA sling. The purpose of this retrospective study was to determine the appropriate indications for surgical intervention for CTS complicated by PA sling.
Methods: We evaluated 42 patients (19 males and 23 females) with the median age of 9.9±3.3 months (range, 5-34 months) with CTS complicated by PA sling who were treated at our hospital between 2005 and 2018. Twenty-eight patients received both a slide tracheoplasty and PA re-implantation, and 14 patients were managed conservatively for CTS. Among the latter, nine patients received PA re-implantation only, and five were managed conservatively without any surgery. We determined the surgical indications by retrospectively comparing the DLR value [tracheal diameter (mm)/stenotic length ratio], history of ventilator respiration, mortality rate, and post-operative course of patients at a single institution.
Results: The cut-off value for the DLR was determined to be 5.9 (sensitivity: 0.929, specificity: 0.714) by using the ROC curve (AUC 0.89, P<0.05).
Conclusions: A DLR value under 5.9 may serve as a new surgical indication for CTS complicated by PA sling.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6987985 | PMC |
| http://dx.doi.org/10.21037/jtd.2019.11.31 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Congenital Fibrolipoma with Hamartomatous Changes of the Internal Jugular Vein: First Published Case Report.
Methodist Debakey Cardiovasc J
December 2024
Cardiothoracic and Vascular Surgery Center, University Hospital, Mansoura University, Dakahliya, Egypt.
A 25-year-old female presented with a congenital painless growing mass on the right side of her neck with symptoms of tinnitus and difficulty breathing. Imaging revealed an aneurysm of the internal jugular vein reaching a maximum diameter of 9.2 cm, shifting the trachea and right thyroid lobe to the left side.
View Article and Find Full Text PDFSlide Tracheoplasty in Long Segment Tracheobronchial Stenosis.
Ann Thorac Surg
December 2024
Paediatric Cardiothoracic and Tracheal Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Background: Long segmental congenital tracheal and tracheobronchial stenosis are a rare congenital airway anomaly with variable arborizations. This study aims to analyze presentations and outcomes of slide- tracheoplasty in long segmental congenital tracheal and tracheobronchial stenosis with variable arborizations METHODS: Retrospective analysis of all patients underwent slide tracheoplasty between March 1995 to Feb 2023 for long segmental congenital tracheal and tracheobronchial stenosis. Preoperative airway morphology was divided into anatomic types based on the Great Ormond Street Children Hospital Morphological Classification.
View Article and Find Full Text PDFTracheal reconstructive surgery under ECMO for the treatment of congenital tracheal stenosis in the premature infant: case report.
Front Pediatr
December 2024
Department of Neonatal Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Henan, China.
Background: Congenital tracheal stenosis (CTS) is a rare but life-threatening malformation of the trachea. Surgical reconstruction is the treatment of choice in symptomatic cases which is highly risky and is rarely performed in extremely premature infants. With this, reporting a case of CTS managed by tracheal reconstructive surgery under ECMO in a baby weighing 1.
View Article and Find Full Text PDFCongenital Tracheal Stenosis With Complete Cartilage Rings: Proposal of A Multidisciplinary and Tailored Surgical Approach.
J Pediatr Surg
December 2024
Division of Pediatric Surgery, Department of Surgery, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147, Genova, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, DINOGMI, Università di Genova, Largo Paolo Daneo 3, 16132, Genova, Italy; Pediatric Thoracic and Airway Surgery Unit, Department of Surgery, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147, Genova, Italy.
Introduction: Congenital Tracheal Stenosis (CTS) with complete cartilaginous rings is a rare but potentially life-threatening condition in paediatric patients. Currently, the most common approach is slide tracheoplasty (ST) with sternotomy under cardiopulmonary bypass (CPB). Intending to make the procedure less invasive and consider the variety of associated conditions, we have tailored the approach to our patients, who were treated by a multidisciplinary airway team.
View Article and Find Full Text PDFEchocardiographic Changes in Infants with Severe Congenital Diaphragmatic Hernia After Fetoscopic Endoluminal Tracheal Occlusion (FETO).
Pediatr Cardiol
December 2024
Division of Pediatric General, Thoracic, and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Fetoscopic endoluminal tracheal occlusion (FETO) induces lung growth and may improve survival in congenital diaphragmatic hernia (CDH) but the effect on post-natal right (RV) and left (LV) ventricular size and cardiac function is unknown. Quantitative measures of heart size and function including tricuspid annular plane systolic excursion Z-score (TAPSEZ), RV fractional area change (RVFAC), RV global longitudinal and free wall strain (RVGLS, RVFWS), RV/LV ratio, LV eccentricity index (LVEI), and LV M-mode diastolic and systolic Z-scores (LVIDDZ, LVIDSZ) were compared between FETO and control patients on first post-natal echocardiogram, prior to and post CDH repair, and on last available echocardiogram using non-parametric Wilcoxon rank-sum test in a single-center, retrospective cohort study. Linear regression models evaluated change over time, adjusting for clustering and interaction of echocardiogram parameters with time.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!