REOPERATION AFTER PERICARDIAL PATCH TRACHEOPLASTY

Between 1982 and 1995, 28 infants underwent pericardial tracheoplasty for long-segment tracheal stenosis, Seven of these infants required re operation or stenting for residual or recurrent tracheal or bronchial stenosis, Revisions were performed 2 to 6 months after the original pr ocedure with cardiopulmonary bypass and bronchoscopic guidance. Two pa tients underwent repeat pericardial patch tracheoplasty, and four pati ents underwent insertion of a rib cartilage graft, Two of these patien ts required Palmaz wire expandable stents and one other patient also u nderwent stent placement, There was one late death 1 year after cartil age graft insertion. The authors identified three risk factors for reo peration after tracheoplasty; younger age at initial surgery and assoc iated pulmonary artery sling or tracheal right upper robe bronchus. Go od intermediate results are possible in this difficult group of childr en using a selective and inclusive strategy for tracheal enlargement t hat includes repeat pericardial tracheoplasty, autologous cartilage gr afts, and expandable wire stents. Copyright (C) 1997 by W.B. Saunders Company.