A technique for thoracoscopic aortopericardiosternopexy.

BACKGROUND

A left thoracotomy is the standard access for aortosternopexy in severe tracheomalacia. We report a modified technique for thoracoscopic aortopericardiosternopexy.

METHODS

The thymus is mobilized, and the needle is passed through the sternum and back. In extensive or recurrent tracheomalacia, not only the ascending aorta but also the innominate artery and pericardial base are fixed to the sternum. The effect is monitored bronchoscopically.

RESULTS

This technique showed dramatic success in two children, one 4-year-old and a 2-year-old. In the younger child, the thoracoscopy was a redo procedure after a previous open aortosternopexy.

CONCLUSIONS

Thoracoscopic aortopericardiosternopexy is an effective procedure that does not impair postoperative respiration. It should therefore be considered for severe tracheomalacia or even redo operations.