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

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TitleTracheobronchography and angiocardiography of paediatric cardiac patients with airway disorders
AuthorsCheung, YF1
Lee, SL1
Leung, MP1
Yung, TC1
Chau, AKT1
Hui, HKY1
Issue Date2002
PublisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JPC
CitationJournal Of Paediatrics And Child Health, 2002, v. 38 n. 3, p. 258-264 [How to Cite?]
DOI: http://dx.doi.org/10.1046/j.1440-1754.2002.00774.x
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.
ISSN1034-4810
2011 Impact Factor: 1.281
2011 SCImago Journal Rankings: 0.091
DOIhttp://dx.doi.org/10.1046/j.1440-1754.2002.00774.x
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorCheung, YF
dc.contributor.authorLee, SL
dc.contributor.authorLeung, MP
dc.contributor.authorYung, TC
dc.contributor.authorChau, AKT
dc.contributor.authorHui, HKY
dc.date.accessioned2012-10-30T06:07:26Z
dc.date.available2012-10-30T06:07:26Z
dc.date.issued2002
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.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationJournal Of Paediatrics And Child Health, 2002, v. 38 n. 3, p. 258-264 [How to Cite?]
DOI: http://dx.doi.org/10.1046/j.1440-1754.2002.00774.x
dc.identifier.doihttp://dx.doi.org/10.1046/j.1440-1754.2002.00774.x
dc.identifier.epage264
dc.identifier.issn1034-4810
2011 Impact Factor: 1.281
2011 SCImago Journal Rankings: 0.091
dc.identifier.issue3
dc.identifier.pmid12047693
dc.identifier.scopuseid_2-s2.0-0036271296
dc.identifier.spage258
dc.identifier.urihttp://hdl.handle.net/10722/170316
dc.identifier.volume38
dc.languageeng
dc.publisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JPC
dc.publisher.placeAustralia
dc.relation.ispartofJournal of Paediatrics and Child Health
dc.relation.referencesReferences in Scopus
dc.subject.meshAirway Obstruction - Complications - Congenital - Diagnosis
dc.subject.meshAngiography - Methods
dc.subject.meshBronchial Diseases - Complications - Diagnosis
dc.subject.meshBronchography - Methods
dc.subject.meshBronchoscopy
dc.subject.meshChild
dc.subject.meshChild, Preschool
dc.subject.meshCohort Studies
dc.subject.meshFemale
dc.subject.meshHeart Catheterization - Methods
dc.subject.meshHeart Defects, Congenital - Complications - Diagnosis
dc.subject.meshHospitals, Pediatric
dc.subject.meshHumans
dc.subject.meshInfant
dc.subject.meshIntubation, Intratracheal - Methods
dc.subject.meshMagnetic Resonance Imaging, Cine - Methods
dc.subject.meshMale
dc.subject.meshRetrospective Studies
dc.subject.meshRisk Assessment
dc.subject.meshSensitivity And Specificity
dc.titleTracheobronchography and angiocardiography of paediatric cardiac patients with airway disorders
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong