Korean Journal of Pediatrics 2005;48(7):737-744.
Published online July 15, 2005.
Airway Compression or Airway Anomaly Causing Respiratory Symptoms in Infants and Children with Cardiovascular Diseases
Ja-Hyeong Kim1, So-Yeon Lee2, Hyo-Bin Kim2, So-Eun Koo2, Sung-Jong Park2, Young-Hui Kim2, In-Suk Park2, Jae-Kon Ko2, Dong-Man Seo3, Soo-Jong Hong2
1Department of Pediatrics, Ulsan University Hospital, Ulsan, Korea
2Department of Pediatrics, Asan Medical Center, College of Medicine, Ulsan University, Seoul, Korea
3Department of Cardiac Surgery, Asan Medical Center, College of Medicine, Ulsan University, Seoul, Korea
심혈관계 질환 환아에서 동반된 기도 압박 및 기도 기형의 임상적 특성
김자형1, 이소연2, 김효빈2, 구소은2, 박성종2, 김영휘2, 박인숙2, 고재곤2, 서동만3, 홍수종2
1울산대학교 의과대학 울산대학교병원 소아과
2서울아산병원 소아과
3서울아산병원 흉부외과
Correspondence: 
Soo-Jong Hong, Email: sjhong@amc.seoul.kr
Abstract
Purpose
: Infants and children with cardiovascular diseases often present with respiratory symptoms. However, missed or delayed evaluation for potential airway problem may complicate overall prognosis. The aim of this study is to determine the clinical characteristics of these patients and explore the cause of airway problem.
Methods
: We reviewed the medical records of 64 patients(M : F=33:31, mean age : 6.3±7.5 months) whose airway problems were proven by computed tomography or bronchoscopy in perioperative periods at the Asan Medical Center from January 1997 to June 2004. Patients were divided into two groups based on the duration of ventilator care : ≤7 days(group 1 : 23 cases, M : F=10 : 13) and >7 days(group 2 : 41 cases, M : F=23 : 18).
Results
: The patients in group 2 significantly developed more post-operative respiratory symptoms than group 1(P<0.001) and had more airway problems including extrinsic obstruction, intrinsic anomaly, and combined problem than group 1 although not significantly different(P=0.082). Among underlying diseases, the most common diseases were vascular anomaly(26.2 percent) and aortic arch anomaly(26.2 percent) in group 1 and pulmonary atresia with ventricular septal defect(22.4 percent) in group 2. The most frequent respiratory symptoms were recurrent wheezing pre-operatively and failure of ventilator weaning post-operatively. The major types of airway anomaly were tracheomalacia and tracheal stenosis(in each case 18.2 percent). Nineteen patients with persistent airway problems underwent aortopexy or other vascular correction. Of the 19 patients, 13(68.4 percent) were improved, but 2 failed in weaning ventilator and 4 died of non-airway problems.
Conclusion
: Early evaluation and treatment for potential airway problems may affect natural or surgical prognosis in patients with cardiovascular diseases presenting with respiratory symptoms.
Key Words: Cardiovascular diseases , Airway problem , Computed tomography , Bronchoscopy , Aortopexy


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