Treatment of 21 pediatric patients with pulmonary artery sling combined with tracheal stenosis

Abstract

Objective Total 21 pulmonary artery sling(PA sling) combined with tracheal stenosis children who received treatment in our hospital were reviewed.The feasibility of treatment strategy including left pulmonary artery(LPA) re-implantation without tracheoplasty was discussed in this study. Methods From April 2009 to November 2015, a total of 21 pediatric patients received surgical treatment due to PA sling with tracheal stenosis.Six patients received LPA re-implantation and trachea intervention simultaneously.The other 15 patients received LPA re-implantation alone to relieve the trachea compression without tracheoplasty.The postoperative strategy including early extubation and CPAP ventilation was employed in PICU. Results A total of 21 PA sling with tracheal stenosis children who underwent surgical treatment in our hospital were recruited.There were 9 females and 12 males.Ages of these children were from 1 months to 10 years old, and body weights were from 2.9 kg to 25.0 kg.Five patients needed mechanical ventilation for severe respiratory symptoms preoperatively.Six patients received LPA re-implantation and tracheal intervention simultaneously.Among them, 3 patients received slide tracheoplasty, and one was discharged after recovery.The remaining 3 patients received tracheal stent implantation, but finally died.The survival rate was 16.7% in these patients.Fifteen patients received LPA re-implantation alone, and slide tracheoplasty was performed in 2 patients for extubation failure who finally died of air leakage.The survival rate of 15 patients who received LPA re-implantation alone was 86.7%. Conclusion The strategy in LPA re-implantation alone to relieve the trachea compression without tracheoplasty and early extubation and CPAP ventilation postoperative may be an ideal treatment for the pediatric patients with PLA sling combined with tracheal stenosis. Key words: Pulmonary artery sling; Tracheal stenosis; Left pulmonary artery re-implantation,