Surgical treatment of airway obstruction associated with congenital heart disease in infants and small children

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Abstract
In the last 12 years, 21 patients age 1 month to 5 years (median, 7months) underwent surgical treatment for severe airway obstructionassociated with congenital heart disease. Plico-suspension of the pulmonaryartery was carried out in 14 patients with documented severe left bronchialcompression by a distended pulmonary artery together with repair ofventricular septal defects (11 patients), repair of large coronary arteryfistula (1), division of ductus (1) and pulmonary artery banding (1), withsubsequent significant relief of compression. Aortopexy was used in 2patients with documented severe tracheal compression by a right aorticarch. Five patients had congenital tracheal stenoses (3 extensive, 2localized). Two of 3 patients with associated complex intracardiacanomalies underwent concomitant repair of both lesions with the use ofcardiopulmonary bypass and 1 had a tracheoplasty and pulmonary arterybanding. Tracheal reconstruction with a cartilaginous graft together withrepair of pulmonary artery sling was carried out in 2 infants. Nineteenpatients are alive and well, at a mean follow-up of 87 months. Inconclusion, we advocate early aggressive surgical intervention to bothlesions to obtain a better result in the management of infants and smallchildren with this difficult and often fatal combination.

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