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TECHNICAL NOTES
A 5-month-old boy who had been operated for esophageal atresia and tracheoesophageal fistula was presented with recurrent life-threatening apneic spells, expiratory stridor and difficulty in feeding, Diagnosis of tracheomalacia was confirmed by bronchoscopy and pericardial flap aortopexy was performed. Pericardial flap aortopexy is a rel atively simple procedure with minimal risk to the aorta. Minimal dissection is required and there are no sutures placed in the aortic wall, thus avoiding the risk of tears.
KEY WORDS: Tracheal diseases, diagnosis - Tracheal diseases, surgery - Tracheal stenosis - Surgical flaps.
Presented at the 1st World Congress of the Pediatric Thoracic Disciplines, Cesme, Izmir, Turkey, April 21-22, 2000.
Tracheomalacia (TM) describes a generalized or localized weakness of the trachea that allows the anterior and posterior tracheal walls to come together during expiration or coughing. TM affects approximately 10 to 20% of infants after repair of esophageal atresia and tracheoesophageal fistula (EA-TEF).1 Most infants with TM do not require surgical intervention, but severe forms of TM may require surgical care. Aortopexy is recognized as the standard surgery for tracheomalacia.2
A modification of standard aortopexy using a pericardial flap rather than direct suture technique has been developed. This novel technique increases the ease, safety and applicability of the procedure.
Case report
A full-term male infant was born with EA-TEF which was diagnosed in the first hours of life. At one day of age, the EATEF was repaired by end-to-end...