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Article: Tracheobronchography and angiocardiography of paediatric cardiac patients with airway disorders

TitleTracheobronchography and angiocardiography of paediatric cardiac patients with airway disorders
Authors
Issue Date2002
PublisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JPC
Citation
Journal Of Paediatrics And Child Health, 2002, v. 38 n. 3, p. 258-264 How to Cite?
Abstract
Objective: We report our experience in combining tracheobronchography and angiocardiography in the assessment of a selected cohort of paediatric cardiac patients with problematic airway disorders. Methodology: The clinical records of 11 patients who underwent 17 studies at a median age of 5.5 months (range 3 months to 10.8 years) were reviewed. Tracheobronchography and angiocardiography were performed under general anaesthesia using a non-ionic contrast agent. The findings were compared with those of flexible bronchoscopy and magnetic resonance imaging (MRI). Results: Seven patients had cardiac lesions associated with vascular anomalies potentially compressing the airway, while four had no identifiable aberrant or enlarged vessels. All examinations but one were performed without complications. Tracheobronchography demonstrated extrinsic vascular compression with secondary airway malacia in three (27%), intrinsic tracheobronchial stenosis in five (45%), and airway malacia in three patients (27%). Precise measurement of the airway calibre and real-time fluoroscopic monitoring facilitated transcatheter tracheobronchial interventions (six balloon dilations, three stent implantations) in four patients. In conjunction with angiocardiography, cine-tracheobronchography provided detailed information on the spatial relationship between vascular and airway structures in all patients; allowed dynamic assessment of airway malacia; and facilitated preoperative planning in six patients. In contrast, bronchoscopy failed to differentiate malacia from extrinsic compression in four patients (36%), while MRI, performed in six patients, was unsatisfactory in one due to a motion artefact and failed to diagnose airway malacia and extrinsic compression in three patients. Conclusions: Tracheobronchography is relatively safe in paediatric cardiac patients. Combined tracheobronchography and angiocardiography, a less operator-dependent imaging modality compared to bronchoscopy and MRI, delineated the airway and vascular anatomy in detail; facilitated preoperative planning; and permitted transcatheter tracheo-bronchial interventions. The dynamic capability of tracheobronchography supplements that of flexible bronchoscopy and MRI in the diagnosis of airway malacia.
Persistent Identifierhttp://hdl.handle.net/10722/170316
ISSN
2013 Impact Factor: 1.193
ISI Accession Number ID
References

 

Author Affiliations
  1. The University of Hong Kong
DC FieldValueLanguage
dc.contributor.authorCheung, YFen_US
dc.contributor.authorLee, SLen_US
dc.contributor.authorLeung, MPen_US
dc.contributor.authorYung, TCen_US
dc.contributor.authorChau, AKTen_US
dc.contributor.authorHui, HKYen_US
dc.date.accessioned2012-10-30T06:07:26Z-
dc.date.available2012-10-30T06:07:26Z-
dc.date.issued2002en_US
dc.identifier.citationJournal Of Paediatrics And Child Health, 2002, v. 38 n. 3, p. 258-264en_US
dc.identifier.issn1034-4810en_US
dc.identifier.urihttp://hdl.handle.net/10722/170316-
dc.description.abstractObjective: We report our experience in combining tracheobronchography and angiocardiography in the assessment of a selected cohort of paediatric cardiac patients with problematic airway disorders. Methodology: The clinical records of 11 patients who underwent 17 studies at a median age of 5.5 months (range 3 months to 10.8 years) were reviewed. Tracheobronchography and angiocardiography were performed under general anaesthesia using a non-ionic contrast agent. The findings were compared with those of flexible bronchoscopy and magnetic resonance imaging (MRI). Results: Seven patients had cardiac lesions associated with vascular anomalies potentially compressing the airway, while four had no identifiable aberrant or enlarged vessels. All examinations but one were performed without complications. Tracheobronchography demonstrated extrinsic vascular compression with secondary airway malacia in three (27%), intrinsic tracheobronchial stenosis in five (45%), and airway malacia in three patients (27%). Precise measurement of the airway calibre and real-time fluoroscopic monitoring facilitated transcatheter tracheobronchial interventions (six balloon dilations, three stent implantations) in four patients. In conjunction with angiocardiography, cine-tracheobronchography provided detailed information on the spatial relationship between vascular and airway structures in all patients; allowed dynamic assessment of airway malacia; and facilitated preoperative planning in six patients. In contrast, bronchoscopy failed to differentiate malacia from extrinsic compression in four patients (36%), while MRI, performed in six patients, was unsatisfactory in one due to a motion artefact and failed to diagnose airway malacia and extrinsic compression in three patients. Conclusions: Tracheobronchography is relatively safe in paediatric cardiac patients. Combined tracheobronchography and angiocardiography, a less operator-dependent imaging modality compared to bronchoscopy and MRI, delineated the airway and vascular anatomy in detail; facilitated preoperative planning; and permitted transcatheter tracheo-bronchial interventions. The dynamic capability of tracheobronchography supplements that of flexible bronchoscopy and MRI in the diagnosis of airway malacia.en_US
dc.languageengen_US
dc.publisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JPCen_US
dc.relation.ispartofJournal of Paediatrics and Child Healthen_US
dc.subject.meshAirway Obstruction - Complications - Congenital - Diagnosisen_US
dc.subject.meshAngiography - Methodsen_US
dc.subject.meshBronchial Diseases - Complications - Diagnosisen_US
dc.subject.meshBronchography - Methodsen_US
dc.subject.meshBronchoscopyen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshCohort Studiesen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Catheterization - Methodsen_US
dc.subject.meshHeart Defects, Congenital - Complications - Diagnosisen_US
dc.subject.meshHospitals, Pediatricen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshIntubation, Intratracheal - Methodsen_US
dc.subject.meshMagnetic Resonance Imaging, Cine - Methodsen_US
dc.subject.meshMaleen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshRisk Assessmenten_US
dc.subject.meshSensitivity And Specificityen_US
dc.titleTracheobronchography and angiocardiography of paediatric cardiac patients with airway disordersen_US
dc.typeArticleen_US
dc.identifier.emailCheung, YF:xfcheung@hku.hken_US
dc.identifier.authorityCheung, YF=rp00382en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1046/j.1440-1754.2002.00774.xen_US
dc.identifier.pmid12047693en_US
dc.identifier.scopuseid_2-s2.0-0036271296en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036271296&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume38en_US
dc.identifier.issue3en_US
dc.identifier.spage258en_US
dc.identifier.epage264en_US
dc.identifier.isiWOS:000175907400010-
dc.publisher.placeAustraliaen_US
dc.identifier.scopusauthoridCheung, YF=7202111067en_US
dc.identifier.scopusauthoridLee, SL=8708381600en_US
dc.identifier.scopusauthoridLeung, MP=7201944800en_US
dc.identifier.scopusauthoridYung, TC=9132842300en_US
dc.identifier.scopusauthoridChau, AKT=35787094400en_US
dc.identifier.scopusauthoridHui, HKY=7005913290en_US

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