Long-term outcomes of children undergoing slide tracheoplasty: An institutional review of 227 patients

Objective: Literature on the slide tracheoplasty (STP) is primarily limited to small institutional experiences. Therefore, the authors analyzed their large institutional experience with STP. Methods: All consecutive patients who underwent thoracic STP on cardiopulmonary bypass (CPB) or extracorporeal membrane oxygenation (ECMO) at the authors' institution from 2001 to 2023 were retrospectively reviewed. Results: Two hundred twenty-seven patients, including 120 (53%) infants and 122 (54%) with congenital heart disease (CHD), were identified. Thirty-two (14%) patients had a single functional lung (SFL). Preoperatively, 44 (19%) patients underwent ≥1 cardiac surgery and 34 (15%) had prior tracheoplasties at outside hospitals requiring revision. Forty-eight (21%) patients were intubated pre-STP. Intraoperatively, 212 (93%) patients underwent CPB perfusion (15 STPs were performed on ECMO), and 78 (34%) patients underwent concomitant cardiac repair. Postoperatively, 94 (42%) patients were extubated early (≤24 hours). In-hospital complications included tracheal dehiscence (5%, n = 12) and airway infection (23%, n = 53). Reinterventions included reintubation (19%, n = 44), endotracheal stent (ETS) placement (8%, n = 18), tracheostomy dependence (5%, n = 11), and novel ECMO cannulation (4%, n = 10). The 5- and 10-year freedom from tracheoplasty revision was 95% and 91%, respectively. Upon multivariable regression, factors significantly (P < .05) associated with postoperative mortality