Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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Posterior Tracheopexy For Severe Tracheomalacia
Dr. Todd Ponsky · 2 min · Published Feb 2018
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What the experts said
The study included EA patients diagnosed with moderate to severe tracheomalacia by immediate preoperative rigid bronchoscopy.
Tracheomalacia assessment was performed in two phases of breathing: spontaneous breathing and while applying a Valsalva maneuver or applying negative pressure.
Bronchoscopic assessment included vocal cords, subglottic area, position of the trachea, posterior membrane ratio to whole circumference, cartilage shape, and tracheal collapse.
24 patients met inclusion criteria during the study period (2019-2022).
The procedure was completed in 22 of 24 patients.
Mean operative time was 118 minutes and mean aortopexy time was 15 minutes.
17 patients were discharged alive with a median postoperative hospital stay of 9 days.
Six patients developed anastomotic leak.
Seven patients died in the early postoperative period.
17 patients were followed up with a mean follow-up period of 26 months.
Seven patients developed symptoms in the form of cough, choking, and difficulty swallowing during follow-up.
Symptoms were analyzed by esophagogram and bronchoscopy as needed.
Five patients had symptoms due to anastomotic stricture and improved after dilatation.
Two patients had symptoms due to development of recurrent tracheomalacia, which was still present in one of these patients.
The remaining patients (after excluding those with stricture or recurrent tracheomalacia) were considered to have successful aortopexy.
The main limitations of this study are the small number of patients and the short follow-up period.
Attention given to tracheomalacia by surgeons may improve quality of life in EA patients.
Preoperative determination of the need for aortopexy may alleviate chronic respiratory conditions and decrease the risk of future surgical intervention.
Up to one-third of EA patients were historically believed to have tracheomalacia.
Recent reports suggest tracheomalacia could be encountered in up to 80% of EA patients.