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Ann Thorac Surg 1997;64:1421
© 1997 The Society of Thoracic Surgeons

Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 1412.

DR CONSTANTINE MAVROUDIS (Chicago, IL): Doctor Jakob and his colleagues are to be congratulated on a significant contribution to the treatment of long-segment tracheomalacia. Their methods are carefully planned, and their data are clear and are well presented. My colleagues and I also agree with their use of cardiopulmonary bypass to achieve proper exposure and stability for the operation.

External tracheal stenting is not new and has been successfully used for the innominate artery compression syndrome as well as an adjunct to pericardial patch tracheoplasty and repair of tetralogy of Fallot with absent pulmonary valve. However, the idea of circumferential PTFE external stenting, as used by Dr Jakob and his associates, represents an ingenious step forward for these very difficult cases.

My colleagues, Carl Backer and Lauren Hollinger, and I have used a slightly different therapeutic approach to achieve internal stabilization by placement of Palmaz stents, which are expandable. Our experience includes 6 ventilator-dependent patients who had persistent long-segment bronchotracheomalacia after tracheoplasty in 5 and repair of tetralogy of Fallot with absent pulmonary valve in 1.

A total of 10 stents were used in 6 patients with good short-term results. One patient had a single ventricle and died of endocarditis, and another patient required stent removal and tracheostomy for control of his airway.

. . . [Full Text of this Article]


Related Article

External Stabilization of Long-Segment Tracheobronchomalacia Guided by Intraoperative Bronchoscopy
Siegfried Hagl, Heinz Jakob, Christian Sebening, Peter van Bodegom, Klaus Schmidt, Eugen Zilow, Franz Fleischer, and Herbert Ulmer
Ann. Thorac. Surg. 1997 64: 1412-1420. [Abstract] [Full Text]





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Copyright © 1997 by The Society of Thoracic Surgeons.