Retrospective Analysis of the Management of Congenital Tracheal Stenosis in Patients Undergoing Pediatric Cardiac Surgery.

CONTEXT: Congenital airway or tracheal stenosis (CTS) during pediatric cardiac surgery (PCS) can modify the perioperative course.

AIM: To find the effect of CTS on mortality and morbidity during PCS.

SETTINGS AND

DESIGN

University hospital; Retrospective observational cohort study.

MATERIAL AND

METHODS

Database of PCS patients between January 2019 and April 2025 was analyzed for the incidence of CTS, and perioperative morbidity and mortality. Redo-surgeries were excluded for analyzing CTS incidence.

STATISTICAL ANALYSIS: Continuous variables are described as median and interquartile range (IQR) of 25-75% and analyzed using the Mann-Whitney U test. A P value of < 0.05 was considered significant.

RESULTS

A total of 4222 patients underwent PCS; 66 underwent redo-surgeries , and 9 (0.21%) had CTS. One neonate died during investigation. CTS was diagnosed preoperatively in two, intraoperatively in five, and postoperatively in one. Two patients who underwent PCS-only had a stormy perioperative course and required emergent tracheoplasty. In the PCS-only, 68 patients (1.9%) died; in PCS with CTS, two patients (25%) died (P < 0.01). Odds ratio for mortality with 95% CI in PCS with CTS was 16.8 (3.3-84.6). Median intensive care unit (ICU) stay with IQR in PCS patients was 72 h (44-144 h); whereas, it was 300 h (120-648 h) in PCS with CTS patients (P < 0.002). Median hospital stay with IQR in PCS patients was 10 days (8-14 days); whereas, it was 15 days (12-47 days) in PCS with CTS patients (P < 0.019).

CONCLUSION

We found a significantly increased mortality of PCS in presence of CTS; it was also associated with increased ICU and hospital stays. PCS with CTS requires concomitant tracheoplasty; PCS alone is unsafe.