Document Detail


One slide fits all: the versatility of slide tracheoplasty with cardiopulmonary bypass support for airway reconstruction in children.
MedLine Citation:
PMID:  21055774     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study describes results of tracheal reconstruction in children with slide tracheoplasty with cardiopulmonary bypass and identifies predictors for adverse outcomes.
METHODS: Preoperative characteristics, operative variables, and outcome measures were collected for children undergoing slide tracheoplasty with cardiopulmonary bypass between April 2001 and October 2009. Predictors of worse outcomes were identified by bivariate analysis. Multiple regression analysis was performed for predictors of prolonged hospital stay.
RESULTS: Cohort included 80 patients (median age, 8.7 months; 7 days-21 years). Forty-eight patients had associated cardiac or great vessel anomalies; 24 had simultaneous repair of cardiovascular anomaly at tracheal reconstruction. Fifty (63%) were extubated within 48 hours after operation. Median stay was 18.5 days (range, 7-119 days). Twenty-three patients (29%) required significant airway reintervention during median follow-up of 12 months (range, 4 months-7.8 years). There were 4 deaths, 2 early and 2 late. In bivariate analysis, age (P = .017), cardiopulmonary bypass duration (P = .025), and duration of mechanical ventilation (P < .05) were associated with mortality; duration of postoperative mechanical ventilation was associated with need for significant airway reintervention (P = .009). Multiple regression analysis indicated preoperative ventilatory support (P < .001), longer cardiopulmonary bypass (P = .002), previous airway operation (P = .01), and need for significant airway reintervention (P < .001) as predictors of longer hospital stay.
CONCLUSIONS: Slide tracheoplasty with cardiopulmonary bypass can be performed with low mortality in a diverse pediatric population. This technique minimizes need for early significant airway reintervention in most cases.
Authors:
Peter B Manning; Michael J Rutter; Asher Lisec; Resmi Gupta; Bradley S Marino
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Publication Detail:
Type:  Journal Article     Date:  2010-11-05
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  141     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-20     Completed Date:  2011-01-13     Revised Date:  2011-08-31    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  155-61     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Division of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. peter.manning@cchmc.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Cardiopulmonary Bypass* / adverse effects,  mortality
Chi-Square Distribution
Child
Child, Preschool
Female
Heart Defects, Congenital / complications,  surgery
Humans
Infant
Infant, Newborn
Length of Stay
Male
Ohio
Regression Analysis
Reoperation
Respiration, Artificial
Retrospective Studies
Risk Assessment
Risk Factors
Sternotomy
Thoracic Surgical Procedures* / adverse effects,  mortality
Time Factors
Trachea / surgery*
Tracheal Stenosis / complications,  mortality,  surgery*
Treatment Outcome
Vascular Malformations / complications,  surgery
Young Adult
Comments/Corrections
Comment In:
J Thorac Cardiovasc Surg. 2011 Aug;142(2):475   [PMID:  21763881 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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