Surgical Reconstruction of Tracheal Stenosis in Conjunction With Congenital Heart Defects Richard D. Mainwaring, MD, Michael Shillingford, MD, Ryan Davies,

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Presentation transcript:

Surgical Reconstruction of Tracheal Stenosis in Conjunction With Congenital Heart Defects Richard D. Mainwaring, MD, Michael Shillingford, MD, Ryan Davies, MD, Peter Koltai, MD, Manchula Navaratnam, MBChB, V. Mohan Reddy, MD, Frank L. Hanley, MD The Annals of Thoracic Surgery Volume 93, Issue 4, Pages 1266-1273 (April 2012) DOI: 10.1016/j.athoracsur.2011.12.063 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Artist's illustration of long-segment tracheal stenosis. The affected length of trachea is composed of complete tracheal rings. These complete rings have limited growth potential in the neonate and infant. The Annals of Thoracic Surgery 2012 93, 1266-1273DOI: (10.1016/j.athoracsur.2011.12.063) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Artist's illustration of the sliding tracheoplasty technique. The trachea is transected obliquely from anterior and superior to posterior and inferior. Counterincisions are then made on the anterior surface of the superior segment of the trachea and the posterior surface of the inferior segment. The two segments of the trachea are then advanced and overlapped. The Annals of Thoracic Surgery 2012 93, 1266-1273DOI: (10.1016/j.athoracsur.2011.12.063) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Artist's illustration demonstrating the completion of the sliding tracheoplasty technique. The repair has been performed with 6-0 polydioxanone suture. Care is taken to avoid both inversion and eversion of the tracheal edges. On completion, the lumen of the tracheal has effectively been doubled at the expense of shortening the trachea by nearly one half. The Annals of Thoracic Surgery 2012 93, 1266-1273DOI: (10.1016/j.athoracsur.2011.12.063) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Artist's illustration of the “sliding bronchoplasty” technique shown (A) before and (B) after repair. The bronchial stenosis is repaired by oblique transection and advancement, as described for the tracheoplasty technique. The Annals of Thoracic Surgery 2012 93, 1266-1273DOI: (10.1016/j.athoracsur.2011.12.063) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions