SESSION TITLE: Interventional Pulmonary SESSION TYPE: Original Investigations PRESENTED ON: 10/08/2018 04:30 PM - 05:30 PM PURPOSE: Tracheobronchoplasty in experienced hands has been shown to improve respiratory symptoms, quality of life and functional status in patients with severe symptomatic tracheobronchomalacia (TBM), or excessive dynamic airway collapse (EDAC)(1). Before surgery, patients undergo a stent trial to determine symptomatic and physiologic (FEV1 and 6 minute walk test (6MWT)) improvement in an effort to mimic therapeutic conditions with tracheobronchoplasty(TBP); if symptoms and objective measurements improve they are considered to have a positive stent trial and candidates for TBP. The aim of this study was to determine the success rate of patients who underwent TBP after stent trial and determine possible factors of TBP failure. METHODS: This was a retrospective study of prospectively collected patients with severe TBM and EDAC who underwent TBP between (2014-2018). We defined TBP success with the following scoring system: 1) improvement of 2/3 symptoms (cough, shortness of breath and ability to clear secretions), 2) improvement in 2/3 questionnaires (MMRC dyspnea scale, CQLQ score, SGRQ quality of life measure) and 3) improvement in FEV1 or 6 MWT. If 2 items were positive, it was considered as a successful surgery at the 3 month follow up RESULTS: Thirty one patients (median age 55.1 (±11.3), 87.1% (n=27 females) were treated with TBP, (64.5%, n=20) were diagnosed with TBM and (35.4%, n=11) with EDAC, all of them underwent stent trial previous to surgery. Relevant comorbidities were gastroesophageal reflux (74.1%, n=23), asthma (45.1%, n=14), obstructive sleep apnea (35.3%, n=11), paradoxical vocal cord dysfunction (22.5%, n=7) and chronic obstructive pulmonary disease (16.1%, n=5). After TBP there was a reduction of symptoms from (100%, n=31) to (84%, n=26) (p:0.00), MMRC dyspnea scale from 3 (IQR 2-3) to 1 (IQR 0-2) (p:0.001), of CQLQ scale from 72 (±15.0) to 56 (±16.6) (p:0.001), of FEV1% from 72.8 (±21.2) to 73 (±18.2), (p:0.9) and 6MWT increased from (1063.9ft, ±309) to (1240.3ft ±371) (p:0.01). (90% n= 28) Patients meet criteria for successful TBP vs (9.6%,n=3) who didn’t. The reasons for failure were high functional status, atypical baseline symptoms, concentric TBM, and untreated comorbidities after surgery such as COPD. CONCLUSIONS: Tracheobronchoplasty results in symptom improvement in the majority of patients with TBM and EDAC after a successful stent trial. Untreated comorbidities such as severe COPD, atypical presenting symptoms, and concentric morphology may predict failure. CLINICAL IMPLICATIONS: Tracheobronchoplasty have symptom improvement in the majority of patients with TBM and EDAC after a successful stent trial. Untreated comorbidities such as severe COPD, atypical presenting symptoms, and concentric morphology may predict failure. DISCLOSURES: No relevant relationships by Daniel Alape-Moya, source=Web Response Consultant relationship with Boston Scientific Please note: $1-$1000 Added 03/02/2018 by Alex Chee, source=Web Response, value=Consulting fee No relevant relationships by Sidhu Gangadharan, source=Web Response No relevant relationships by Fayez Kheir, source=Web Response Consultant relationship with Boston Scientific Please note: $5001 - $20000 Added 03/04/2018 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with Olympus Please note: $5001 - $20000 Added 03/04/2018 by Adnan Majid, source=Web Response, value=Consulting fee No relevant relationships by Mihir Parikh, source=Web Response No relevant relationships by Melibea Sierra, source=Web Response no disclosure on file for Jennifer Wilson