[Aortopexy for treatment of severe tracheomalacia, report of three cases]

ABSTRACT

Tracheomalacia is abnormal collapse of the tracheal wall. It may occur in an isolated lesion or can be found in combination with other lesions that cause compression of the airway tracts. Tracheomalacia is usually benign, with symptoms due to airway obstruction. Recurrent pneumonia is common in these patients, presumably because airway collapse during coughing prevents effective clearance of airway secretion. The majority of these patients will respond to conservative management, consisting of humidified air, chest physiotherapy, slow and careful feedings, and control of infection and secretion with antibiotics. Surgical therapy is required when conservative measures are not adequate or when reflex apnea is present. Surgery includes correction of the underlying cause, such as vascular ring, teracheostomy, and aortopexy aortopexy is the accepted operative treatment for severe tracheomalacia. The standard surgical approach involves a left anterior thoracotomy often under broncoscopic control. In this paper we report aortopexy in 3 patients with severe, intractable tracheomalacia secondary to esophageal atresia, bronchogenic cyst and huge mediastinal cystic lymphangioma. The children with airway obstruction with or without lung infection especially in patients susceptible to tracheomalacia should examine with rigid bronchoscope for diagnosis. If bronchomalacia confirmed and conservative managements were not effective, aortopexy is one of the treatment modalities that were effective in our patients with good to excellent results: