Important excess morbidity due to upper airway anomalies in the perioperative course in infant cardiac surgery

Pfammatter, Jean-Pierre; Casaulta, Carmen; Pavlovic, Mladen; Berdat, Pascal A; Frey, Urs; Carrel, Thierry (2006). Important excess morbidity due to upper airway anomalies in the perioperative course in infant cardiac surgery. Annals of thoracic surgery, 81(3), pp. 1008-12. New York, N.Y.: Elsevier 10.1016/j.athoracsur.2005.09.015

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BACKGROUND: The study aimed at defining the excess morbidity or mortality caused by an additional airway malformation in children with congenital heart disease requiring surgery. METHODS: All patients requiring surgery for heart disease during an 8-year period ending in 2003 who had an associated upper airway malformation were retrospectively studied. All patients were seen in 2004 for a prospective follow-up examination. RESULTS: Eleven patients with upper airway anomalies were identified (tracheobronchial malacia in 6 patients, long-segment tracheal stenosis in 3, and bilateral vocal cord paralysis and tracheal hemangioma in 1 patient each). They accounted for 1.5% of the entire cardiac surgical load of 764 patients. In 5 infants, the airway anomaly was diagnosed before cardiac repair, in 6 patients thereafter. Diagnosis was made by bronchoscopy in all patients, by additional bronchography in 2. Failure of rapid postoperative extubation was the most common finding. Airway management was surgical in 2 and conservative in 8 patients, 1 newborn having been denied therapy because of the severity of airway hypoplasia. Compared with patients with isolated cardiac disease, those with additional airway anomalies had significantly longer duration of postoperative mechanical ventilation (median, 24 days versus 3), perioperative hospitalization (median, 72 days versus 11) and total number of days of hospitalization during the first year of life (median, 104 days versus 14). After a maximum follow-up of 8 years (median, 37 months) only 3 of 10 surviving patients remained symptomatic owing to the airway malformation. CONCLUSIONS: Upper airway anomalies accompanying heart disease in infancy resulted in a significant prolongation of perioperative intensive care and hospital stay, as well as duration of mechanical ventilation. Failure of early postoperative extubation was the leading symptom.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

Pfammatter, Jean-Pierre; Casaulta Aebischer, Carmen; Pavlovic, Mladen; Berdat, Pascal; Frey, Urs Peter and Carrel, Thierry

ISSN:

0003-4975

ISBN:

16488711

Publisher:

Elsevier

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:48

Last Modified:

06 Dec 2013 13:42

Publisher DOI:

10.1016/j.athoracsur.2005.09.015

PubMed ID:

16488711

Web of Science ID:

000235844100036

URI:

https://boris.unibe.ch/id/eprint/19972 (FactScience: 3051)

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