Sutton, Liam;
Maughan, Elizabeth;
Pianosi, Kiersten;
Jama, Guled;
Rouhani, Maral J;
Hewitt, Richard;
Muthialu, Nagarajan;
... De Coppi, Paolo; + view all
(2024)
Open and Thoracoscopic Aortopexy for Airway Malacia in Children: 15 Year Single Centre Experience.
Journal of Pediatric Surgery
, 59
(2)
pp. 197-201.
10.1016/j.jpedsurg.2023.10.016.
Preview |
Text
1-s2.0-S0022346823006267-main.pdf - Accepted Version Download (1MB) | Preview |
Abstract
Objectives: The objective was to report and analyse the characteristics and results of open aortopexy and thoroscopic aortopexy for the treatment of airway malacia in a paediatric population. / Methods: We report a retrospective consecutive case series of paediatric patients undergoing aortopexy for the treatment of airway malacia at a quaternary referral centre between December 2006 and January 2021. Outcome measures included days to extubation, continued need for non-invasive ventilation, further intervention in the form of tracheostomy and death. / Results: 169 patients underwent aortopexy: 147 had open procedures (135 via median/limited median sternotomy and 12 thoracotomy) and 22 thoracoscopic. Mean follow up was 8.46 yrs (range 1-20 yrs). Most common site of airway malacia was the trachea (n=106, 62.7%), and 48(28.4%) had additional involvement at the bronchi with tracheobronchomalacia(TBM). 15(8.9%) had bronchomalacia(BM) only. Incidence of bronchial disease was lower in the thoracoscopic than open group (13.6% vs 40.82%; p<0.0001). Mean time to extubation was 1.45 days, 2.59 days, 5.23 days in tracheomalacia, TBM and BM groups, respectively (p=0.0047). Mean time to extubation was 1.35 days, 2 days, 3.67 days, and 5 days in patients with external vascular compression, TOF/OA, primary airway malacia, and laryngeal reconstruction, respectively (p=0.0002). There were 21 deaths across the cohort, and all were in the open group. 71.4% (n=15) had bronchial involvement of their airway malacia. / Conclusions: Open and thoroscopic aortopexy are effective treatments for airway malacia in children. We have identified that involvement of the bronchi is a risk factor for adverse outcomes, and the optimum treatment for this patient cohort is still debatable. / Level of Evidence: IV / Type of Study: Retrospective Study
| Type: | Article |
|---|---|
| Title: | Open and Thoracoscopic Aortopexy for Airway Malacia in Children: 15 Year Single Centre Experience |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jpedsurg.2023.10.016 |
| Publisher version: | https://doi.org/10.1016/j.jpedsurg.2023.10.016 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Aortopexy, Tracheomalacia, Tracheopexy, Tracheobronchomalacia, Bronchomalacia |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10179888 |
Archive Staff Only
 |
View Item |
