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Pediatric Surgery International

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01-12-2023 | Bronchoscopy | Original Article

Incidence of congenital tracheal stenosis in left pulmonary artery sling diagnosed by bronchoscopy

Authors: Emi Tsuji, Keiichi Morita, Hironori Matsuhisa, Yuko Bitoh, Tadashi Hatakeyama

Published in: Pediatric Surgery International | Issue 1/2023

Abstract

Purpose

Congenital tracheal stenosis (CTS) has been reported to occur in 50–65% of cases of left pulmonary artery sling (LPAS), but the exact incidence rate is unknown. This study aimed to determine the actual rate using bronchoscopy and to elucidate morphological features in computed tomography (CT) diagnosis.

Methods

We performed a single institutional retrospective review of all patients with LPAS between January 2010 and March 2022. The percentage of complete tracheal rings in patients with LPAS was evaluated using bronchoscopy. The anteroposterior/lateral diameter ratios at the smallest and largest diameters of each CTS patient’s trachea were measured on CT. The Wilcoxon signed-rank test was used to analyze the differences between the two parts.

Results

Fifty-two patients with LPAS were enrolled. All patients had complete tracheal rings on bronchoscopy. CT analysis of 32 patients with CTS was performed. The median anteroposterior/lateral diameter ratio at the smallest diameter was 1.05 (interquartile range [IQR] 0.95–1.15); the median ratio at the largest diameter was 0.94 (IQR 0.89–0.99). There was a significant difference between the two parts (p = 0.013).

Conclusion

CTS might be universally associated with LPAS. The circular tracheal cross-section on CT might imply the existence of a complete tracheal ring.

Berdon WE, Baker DH, Wung JT et al (1984) Complete cartilage-ring tracheal stenosis associated with anomalous left pulmonary artery: the ring-sling complex. Radiology 152:57–64. https://doi.org/10.1148/radiology.152.1.6729137CrossRefPubMed

Cohen SR, Landing BH (1976) Tracheostenosis and bronchial abnormalities associated with pulmonary artery sling. Ann Otol Rhinol Laryngol 85:582–590. https://doi.org/10.1177/000348947608500504CrossRefPubMed

Torre M (2017) Left pulmonary artery sling and congenital tracheal stenosis: to slide or not to slide? J Thorac Dis 9:4881–4883. https://doi.org/10.21037/jtd.2017.11.76CrossRefPubMedPubMedCentral

Fiore AC, Brown JW, Weber TR, Turrentine MW (2005) Surgical treatment of pulmonary artery sling and tracheal stenosis. Ann Thorac Surg 79:38–46. https://doi.org/10.1016/j.athoracsur.2004.06.005CrossRefPubMed

Huang SC, Wu ET, Wang CC et al (2012) Surgical management of pulmonary artery sling: trachea diameter and outcomes with or without tracheoplasty. Pediatr Pulmonol 47:903–908. https://doi.org/10.1002/ppul.22516CrossRefPubMed

Choi ES, Park CS, Kim DH et al (2022) Outcomes of pulmonary artery sling repair without tracheoplasty. J Thorac Cardiovasc Surg S0022–5223(22):01255–01257. https://doi.org/10.1016/j.jtcvs.2022.11.017CrossRef

Binsalamah ZM, Thomason A, Ibarra C et al (2021) Midterm outcomes of pulmonary artery sling repair with and without tracheoplasty. Cardiol Young 31:52–59. https://doi.org/10.1017/s1047951120003212CrossRefPubMed

Kwak JG, Kim WH, Min J, Lee C, Jang W, Lee CH (2013) Is tracheoplasty for all patients with pulmonary artery sling and tracheal stenosis? Pediatr Cardiol 34:498–503. https://doi.org/10.1007/s00246-012-0481-7CrossRefPubMed

Backer CL, Russell HM, Kaushal S, Rastatter JC, Rigsby CK, Holinger LD (2012) Pulmonary artery sling: current results with cardiopulmonary bypass. J Thorac Cardiovasc Surg 143:144–151. https://doi.org/10.1016/j.jtcvs.2011.09.038CrossRefPubMed

10.

Oshima Y, Yamaguchi M, Yoshimura N et al (2008) Management of pulmonary artery sling associated with tracheal stenosis. Ann Thorac Surg 86:1334–1338. https://doi.org/10.1016/j.athoracsur.2008.04.020CrossRefPubMed

11.

Manning PB, Rutter MJ, Lisec A, Gupta R, Marino BS (2011) One slide fits all: the versatility of slide tracheoplasty with cardiopulmonary bypass support for airway reconstruction in children. J Thorac Cardiovasc Surg 141:155–161. https://doi.org/10.1016/j.jtcvs.2010.08.060CrossRefPubMed

12.

Hong X, Li R, Zhao Z et al (2020) Tracheal development after left pulmonary artery reimplantation: an individual study. Sci Rep 10:17702. https://doi.org/10.1038/s41598-020-74890-4CrossRefPubMedPubMedCentral

13.

Muthialu N, Martens T, Kanakis M et al (2020) Repair of pulmonary artery sling with tracheal and intracardiac defects. Asian Cardiovasc Thorac Ann 28:463–469. https://doi.org/10.1177/0218492320943342CrossRefPubMed

Title: Incidence of congenital tracheal stenosis in left pulmonary artery sling diagnosed by bronchoscopy
Authors: Emi Tsuji
Keiichi Morita
Hironori Matsuhisa
Yuko Bitoh
Tadashi Hatakeyama
Publication date: 01-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Bronchoscopy
Computed Tomography
Computed Tomography
Published in: Pediatric Surgery International / Issue 1/2023
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-023-05527-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Incidence of congenital tracheal stenosis in left pulmonary artery sling diagnosed by bronchoscopy

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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