Intermediate to late results of surgical relief of vascular tracheobronchial compression

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Abstract
Since 1979, a total of 69 infants and children aged 0.1 to 11.9 (median0.7) years required surgical intervention for: double aortic arch (26),anomalous origin of innominate artery (26), right aortic arch with leftligamentum arteriosum (9), pulmonary artery sling (5), retroesophagealright subclavian artery (3). Before operation, the morbidity was high: 84%of children were symptomatic in the first trimester of life with 24patients requiring mechanical ventilation. Seven children had anaccompanying heart defect. Left thoracotomy was the preferred approach.There were 2 early (asphyxic brain damage, postoperative pneumonia) and 2late (tracheomalacia, complex heart defect) deaths. Five patients (2originally operated elsewhere) needed reoperation for persistent symptoms.All 65 survivors are well 1 month to 11.9 (mean 3.9 +/- 3.62) years aftersurgery. Tracheobronchoscopy, magnetic resonance imaging, and lung functiontesting were helpful for postoperative evaluation. Minor trachealcompression was revealed in 4 patients despite their good clinicalcondition.

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