Surgical Management of Bridging Bronchus Associated with Congenital Heart Disease and Tracheal Stenosis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 WANGShun-min , XUZhi-wei , ZhuLi-min , ZHANGHai-bo , ZHENGJing-hao , LIUJin-fen

Department of Thoracic and Cardiovascular Surgery, Shanghai Children's Medical Center, Medical College of Shanghai Jiaotong University, Shanghai 200127, P. R. China;

Corresponding author：

WANGShun-min, Email: smwang780@hotmail.com

Keywords：

Bridging bronchus; Tracheal stenosis; Congenital heart disease; Surgery

DOI：

10.7507/1007-4848.20160163

Video：

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Objective To summarize our clinical experience of side-slide tracheoplasty in surgical management of bridging bronchus associated with congenital tracheal stenosis(CTS) and congenital heart disease (CHD). Method We retrospectively analyzed the clinical data of 8 bridging bronchus patients associated with CTS and CHD underwent tracheoplasty in our hospital from January 2010 through June 2015. There were 3 males and 5 females at age of 19.6±9.1 months and weight of 9.9±5.4 kg in our hospital. It was found that main tracheal associated with intermediate bronchus stenosis in 4 patients. Complete tracheal rings or bronchial rings were identified in all cases. Less than 50% normal tracheal size was found in all patients. Correction of CHD and tracheoplasty were done under cardiopulmonary bypass at the same stage. The technique of side-slide tracheoplasty was used in all patients. Results Average cardiopulmonary bypass time was 64.0±24.1 min. Average aortic clamp time was 14.0±18.1 min. No operative death occurred in hospital. The average duration of postoperative hospital stay was 20 d. Follow-up was completed in 8 patients. The duration of follow-up was 1 month to 5 years. Tracheal granulation occurred in one patient after six weeks of postoperation. The clinical symptoms improved significantly in the remaining patients. Conclusions Bridging bronchi has special anatomical features. The technique of side-slide tracheoplasty can be used to correct bridging bronchus associated with CTS with satisfactory outcomes.

Citation： WANGShun-min, XUZhi-wei, ZhuLi-min, ZHANGHai-bo, ZHENGJing-hao, LIUJin-fen. Surgical Management of Bridging Bronchus Associated with Congenital Heart Disease and Tracheal Stenosis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(7): 679-683. doi: 10.7507/1007-4848.20160163 Copy

1.	Gonzalez-Crussi F, Padilla LM, Miller JK, et al. Bridging bronchus. Am J Dis Child, 1976, 130(9) :1015-1018.
2.	Hagl S, Sebening C, Springer W, et al. Modified sliding tracheal plasty using the bridging bronchus for repair of long-segment tracheal stenosis. Ann Thorac Surg, 2008, 85(3) :1118-1120.
3.	Beierlein W, Elliott MJ. Variations in the technique of slide tracheoplasty to repair complex forms of long-segment congenital tracheal stenoses. Ann Thorac Surg, 2006, 82(4) :1540-1542.
4.	Freitag L, Ernst A, Unger M, et al. A proposed classification system of central airway stenosis. Eur Respir J, 2007, 30(1) :7-12.
5.	Ghaye B, Fanchamps FM, Dondelinger RF, et al. Congenital bronchial abnormalities revisited. Radiographics, 2001, 21(1) :105-119.
6.	Wells TR, Gwinn JL, Landing BH, et al. Reconsideration of the anatomy of sling left pulmonary artery:the association of one form with bridging bronchus and imperforate anus. Anatomic and diagnostic aspects. J Pediatr Surg, 1988, 23(10) :892-898.
7.	Zhong YM, Jaffe RB, Zhu M, et al. CT assessment of tracheobron-chial anomaly in left pulmonary artery sling. Pediatr Radiol, 2010, 40(11) :1755-1762.
8.	Effmann EL, Fram EK, Vock P, et al. Tracheal crosssectional area in children:CT determination. Radiology, 1983, 149(1) :137-140.
9.	Tsang V, Murday A, Gillbe C, et al. Slide tracheoplasty for congen-ital funnel-shaped tracheal stenosis. Ann Thorac Surg, 1989, 48 (5) :632-635.
10.	Simone S, Thomas WG, Mike B, et al. Do tracheas grow after slide tracheoplasty? Ann Thorac Surg, 2012, 93(4) :1083-1087.
11.	Li X, Cheng LC, Cheung YF, et al. Management of symptomatic congenital tracheal stenosis in neonates and infants by slide tracheo-plasty:a 7-year single institution experience. Eur J Cardiothorac Surg, 2010, 38(5) :609-614.
12.	Manning PB, Rutter MJ, Border WL. Slide tracheoplasty in infants and children:risk factors for prolonged postoperative ventilatory support. Ann Thorac Surg, 2008, 85(4) :1187-1191.
13.	Manning PB, Rutter MJ, Lisec A, et al. One slide fits all:the versatility of slide tracheoplasty with cardiopulmonary bypass support for airway reconstruction in children. J Thorac Cardiovasc Surg, 2011, 141(1) :155-161.
14.	徐志伟, 王顺民, 陆兆辉, 等. Slide方法在小儿先天性气管狭窄的应用. 中华小儿外科杂志, 2011, 32(3) :165-168.
15.	Xue B, Liang B, Wang S, et al. One-stage surgical correction of congenital tracheal stenosis complicated with congenital heart disease in infants and young children. J Card Surg, 2015, 30(1) :97-103.
16.	Elliott MJ, Speggiorin S, Vida VL, et al. Slide tracheoplasty as a rescue technique after unsuccessful patch tracheoplasty. Ann Thorac Surg, 2009, 88(3) :1029-1031.
17.	Butler CR, Speggiorin S, Rijnberg FM, et al. Outcomes of slide tracheoplasty in 101 children:a 17-year single-center experience. J Thorac Cardiovasc Surg, 2014,147(6) :1783-1789.
18.	Backer CL, Russell HM, Kaushal S, et al. Pulmonary artery sling:current results with cardiopulmonary bypass. J Thorac Cardiovasc Surg, 2012, 143(1) :144-151.
19.	Fiore AC, Brown JW, Weber TR, et al. Surgical treatment of pulmonary artery sling and tracheal stenosis. Ann Thorac Surg, 2005,79(1) :38-46.
20.	Grillo HC. Slide tracheoplasty for long-segment congenital tracheal stenosis. Ann Thorac Surg, 1994, 58(3) :613-621.

1. Gonzalez-Crussi F, Padilla LM, Miller JK, et al. Bridging bronchus. Am J Dis Child, 1976, 130(9) :1015-1018.
2. Hagl S, Sebening C, Springer W, et al. Modified sliding tracheal plasty using the bridging bronchus for repair of long-segment tracheal stenosis. Ann Thorac Surg, 2008, 85(3) :1118-1120.
3. Beierlein W, Elliott MJ. Variations in the technique of slide tracheoplasty to repair complex forms of long-segment congenital tracheal stenoses. Ann Thorac Surg, 2006, 82(4) :1540-1542.
4. Freitag L, Ernst A, Unger M, et al. A proposed classification system of central airway stenosis. Eur Respir J, 2007, 30(1) :7-12.
5. Ghaye B, Fanchamps FM, Dondelinger RF, et al. Congenital bronchial abnormalities revisited. Radiographics, 2001, 21(1) :105-119.
6. Wells TR, Gwinn JL, Landing BH, et al. Reconsideration of the anatomy of sling left pulmonary artery:the association of one form with bridging bronchus and imperforate anus. Anatomic and diagnostic aspects. J Pediatr Surg, 1988, 23(10) :892-898.
7. Zhong YM, Jaffe RB, Zhu M, et al. CT assessment of tracheobron-chial anomaly in left pulmonary artery sling. Pediatr Radiol, 2010, 40(11) :1755-1762.
8. Effmann EL, Fram EK, Vock P, et al. Tracheal crosssectional area in children:CT determination. Radiology, 1983, 149(1) :137-140.
9. Tsang V, Murday A, Gillbe C, et al. Slide tracheoplasty for congen-ital funnel-shaped tracheal stenosis. Ann Thorac Surg, 1989, 48 (5) :632-635.
10. Simone S, Thomas WG, Mike B, et al. Do tracheas grow after slide tracheoplasty? Ann Thorac Surg, 2012, 93(4) :1083-1087.
11. Li X, Cheng LC, Cheung YF, et al. Management of symptomatic congenital tracheal stenosis in neonates and infants by slide tracheo-plasty:a 7-year single institution experience. Eur J Cardiothorac Surg, 2010, 38(5) :609-614.
12. Manning PB, Rutter MJ, Border WL. Slide tracheoplasty in infants and children:risk factors for prolonged postoperative ventilatory support. Ann Thorac Surg, 2008, 85(4) :1187-1191.
13. Manning PB, Rutter MJ, Lisec A, et al. One slide fits all:the versatility of slide tracheoplasty with cardiopulmonary bypass support for airway reconstruction in children. J Thorac Cardiovasc Surg, 2011, 141(1) :155-161.
14. 徐志伟, 王顺民, 陆兆辉, 等. Slide方法在小儿先天性气管狭窄的应用. 中华小儿外科杂志, 2011, 32(3) :165-168.
15. Xue B, Liang B, Wang S, et al. One-stage surgical correction of congenital tracheal stenosis complicated with congenital heart disease in infants and young children. J Card Surg, 2015, 30(1) :97-103.
16. Elliott MJ, Speggiorin S, Vida VL, et al. Slide tracheoplasty as a rescue technique after unsuccessful patch tracheoplasty. Ann Thorac Surg, 2009, 88(3) :1029-1031.
17. Butler CR, Speggiorin S, Rijnberg FM, et al. Outcomes of slide tracheoplasty in 101 children:a 17-year single-center experience. J Thorac Cardiovasc Surg, 2014,147(6) :1783-1789.
18. Backer CL, Russell HM, Kaushal S, et al. Pulmonary artery sling:current results with cardiopulmonary bypass. J Thorac Cardiovasc Surg, 2012, 143(1) :144-151.
19. Fiore AC, Brown JW, Weber TR, et al. Surgical treatment of pulmonary artery sling and tracheal stenosis. Ann Thorac Surg, 2005,79(1) :38-46.
20. Grillo HC. Slide tracheoplasty for long-segment congenital tracheal stenosis. Ann Thorac Surg, 1994, 58(3) :613-621.

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Surgical Management of Bridging Bronchus Associated with Congenital Heart Disease and Tracheal Stenosis

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