MANAGEMENT OF SEVERE CONGENITAL TRACHEAL STENOSIS

We have managed 23 infants and children with severe tracheal stenosis due to congenital complete tracheal rings producing a long-segment ste nosis of the trachea. Nineteen (83%) have survived this life-threateni ng cause of airway obstruction, 7 of whom also had pulmonary artery sl ings. Pericardial patch tracheoplasty facilitated by partial cardiopul monary bypass is currently our preferred technique for surgical repair . Eighteen patients (78%) underwent operative intervention, 3 of whom (17%) have died since surgery. The mean follow-up is 4.5 years. Bronch oscopy is essential for preoperative diagnosis and accurate intraopera tive incision of the trachea, and is critical for long-term postoperat ive airway management. The more distal lesions are associated with inc reased complications and a higher mortality rate.