ABSTRACT
A female newborn presented with respiratory distress at birth and was diagnosed with congenital tracheal stenosis. The stenosis was positioned at the distal trachea and compromised the carina and the right and left bronchi. She underwent surgical treatment using circulatory life support with veno-arterial peripheral extracorporeal membrane oxygenation, and the airway was reconstructed using the slide tracheoplasty technique to build a neocarina. The patient had an excellent postoperative course, was successfully weaned from extracorporeal membrane oxygenation and invasive ventilation, and was discharged.
Subject(s)
Bronchi , Extracorporeal Membrane Oxygenation , Plastic Surgery Procedures , Trachea , Tracheal Stenosis , Humans , Female , Tracheal Stenosis/surgery , Tracheal Stenosis/congenital , Tracheal Stenosis/diagnostic imaging , Infant, Newborn , Trachea/surgery , Trachea/abnormalities , Trachea/diagnostic imaging , Extracorporeal Membrane Oxygenation/methods , Bronchi/surgery , Bronchi/abnormalities , Bronchi/diagnostic imaging , Plastic Surgery Procedures/methods , Treatment OutcomeSubject(s)
Lung Neoplasms , Robotic Surgical Procedures , Robotics , Solitary Pulmonary Nodule , Humans , Lung , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Thoracoscopy , Thoracic Surgery, Video-Assisted , Solitary Pulmonary Nodule/diagnostic imaging , Solitary Pulmonary Nodule/surgeryABSTRACT
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.
