Repair of long-segment tracheal stenosis in infancy

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Presentation transcript:

Repair of long-segment tracheal stenosis in infancy Robert D.B. Jaquiss, MDa (by invitation), Rodney P. Lusk, MDb (by invitation), Thomas L. Spray, MDc, Charles B. Huddleston, MDa (by invitation)  The Journal of Thoracic and Cardiovascular Surgery  Volume 110, Issue 5, Pages 1504-1512 (November 1995) DOI: 10.1016/S0022-5223(95)70074-9 Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 1 Before sternal splitting, a segment of cartilage is harvested from the sixth or seventh rib. The cartilage is then tailored to correspond to the subsequent tracheotomy. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 1504-1512DOI: (10.1016/S0022-5223(95)70074-9) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 2 Exposure of the trachea through a sternotomy is demonstrated, including the relative positions of bypass cannulas and retraction of the great vessels for optimum exposure. The distal end of the tracheotomy is typically extended all the way to the carina. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 1504-1512DOI: (10.1016/S0022-5223(95)70074-9) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 3 Placement of the cartilage graft is indicated. The graft is oriented with preserved perichondrium placed on the lumenal side and secured with interrupted nonabsorbable monofilament suture. Intraluminal suture exposure is avoided and the graft is seated on the tracheotomy, rather than being allowed to prolapse into the lumen. The distal end of the endotracheal tube is indicated by a dotted line. Note that this is well above the carina and distal end of the graft. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 1504-1512DOI: (10.1016/S0022-5223(95)70074-9) Copyright © 1995 Mosby, Inc. Terms and Conditions