Clinical Analysis Of Congenital Heart Disease With Airway Anomalies In Children

Objective: To investigate the clinical features and correlation ofcongenital heart disease with airway anomalies in children.Method:460cases of congenital heart disease underwent chestmultidetector helical CT airway reconstruction and/or fiberobronchoscopyhospitalized in Children＇s Hospital of Chongqing Medical University fromJan.2012to Dec.2012were collected in this study. The clinical dataincluding clinical features, ultrasonic cardiogram, chest multidetector helicalCT airway reconstruction, and the fiberobronchoscopy inspection resultswere retrospectively analyzed. The treatment, outcome and prognosis of195cases of congenital heart disease with airway anomalies wereevaluated.Results:1.195cases of congenital heart disease accompanied withairway anomalies, and accounted for42.4%（195/460）in all cases ofcongenital heart disease.323children underwent chest multidetector helicalCT airway reconstruction and/or fiberobronchoscopy from Oct.2012toDec.2012, of which62children accompanied with airway anomalies, and accounted for19.2%（62/323）.2. The type of airway anomalies includedairway stenosis, tracheal bronchus, symmetrical bronchus and airwaymalacia. Among them, airway stenosis was most common(77.4%,151/195）， mainly result from extrinsic compression by vascularmalformation or enlarged heart (51.0%,77/151）.3. The type of congenitalheart disease accompanied with airway anomalies included left-to-rightshunt, outlet obstructive constipation, cyanosis, vascular rings and others.The morbidity of different kinds of congenital heart disease with airwayanomalies was different （vascular rings,84.2%; outlet obstructiveconstipation,51.5%; cyanosis,49.1%; left-to-right shunt,33.8%）. Thepossibility of complex congenital heart disease was higher to accompanywith airway anomalies than uncomplex congenital heart disease（49.6%vs39.5%，P＜0.05). Vascular rings was more likely to accompany withairway anomalies than non vascular rings（76.2%vs40.3%，P＜0.05）.4.The group of airway anomalies was more likely to result in wheezing andrepeated pneumonia than the group of non airway anomalies.102in195cases underwent cardiac surgery without airway correction.10of85caseswith airway stenosis within3months to2years of discharge underwentmultidetector helical CT airway reconstruction. There were no airwaystenosis in6cases (after1~2years), and airway stenosis improved in2cases (after6months).9cases died at the time of hospitalization,13casesdied during follow-up, the all mortality was18.2%（22/121）. Conclusion: The morbidity of congenital heart disease with airwayanomalies was high. Airway stenosis was the most common type. Clinicalmanifestation of congenital heart disease with airway anomalies was notspecific. It would be noticed that vascular rings, complex congenital heartdisease or those cases of congenital heart disease who had repeatedlyrespiratory infection, wheeze, long-term pulmonary atelectasis orpulmonary consolidation of postoperation and failure of ventilator weaningmight accompany with airway anomalies. Conservative management wasthe first choice to mild to moderate airway stenosis. After release ofextrinsic compression, airway stenosis could improve, and even recovernormal in a part of patients.