The Surgical Management Of Congenital Heart Disease Combined With Tracheal Stenosis In Infants

Objective: To introduce our experience of surgical treatment ofcongenital heart disease combined with tracheal stenosis.Methods：We collected1999cases of congenital heart diseaseunderwent operation from Oct.2009to Oct.2014. Forty-eight cases(27boys and21girls, aged1.6to76months, weighted4to20kg)diagnosed tracheal stenosis simultaneous. All patients underwent chestX-ray, echocardiography and CT pre-operation. The CT airway remodelingreminded different length(11%～62%) and severity(29%~74%) of trachealstenosis. One case underwent simultaneous surgical repair of congenitaltracheal stenosis and congenital heart disease. One patient accepted therepair of congenital tracheal stenosis after the treatment of congenital heartmalformations35days later. The remaining46cases only repaired thecardiovascular malformations and loosen the surrounding tissue ofstenosis segment.Results: The postoperative ICU stay was1to74days, median5days,mechanical ventilation2~1104h, median22h,9patients (18.8%) were died in hospital, The remaining39cases discharged from the hospital, butone case died of respiratory infections after discharge10days.Conclusion: When the children with congenital heart disease havesuch clinical manifestations as chronic cough, wheezing, difficultybreathing, we need to highly consider of the existence of tracheal stenosis;The CT airway reconstruction should be performed, and bronchoscopycould further clarify the scope and degree of stenosis; Because of children’strachea development was particularity, we recommended give priority tothe treatment of congenital heart disease, conservative treatment was as faras possible for the trachea.