Outcomes of pulmonary artery sling repair without tracheoplasty

Objective: This study aimed to investigate surgical outcomes of pulmonary artery (PA) sling without tracheoplasty. Methods: From 2001 through 2020, among 22 patients who underwent PA sling repair, all but 1 patient who underwent concomitant tracheal surgery were analyzed. The outcomes of interest were all-cause death, PA reintervention, tracheal inter-vention, and readmission for respiratory symptoms. Computed tomography was used to measure the narrowest tracheal diameter. Results: The median age and weight at repair were 7.6 months and 7.7 kg, respec-tively. Most patients (20 out of 21, 95.2%) had preoperative respiratory symptoms. Associated airway anomalies included tracheal ring in 12 (57.1%), bridging bronchus in 8 (38.1%), and tracheal bronchus in 2 patients (9.5%). There was 1 in-hospital death (4.8%). The median ventilator time and intensive care unit stay were 23 hours and 3 days, respectively. There was neither late death nor tracheal intervention dur -ing follow-up. Five patients (25.0%) underwent reintervention for left PA stenosis. Hospital readmission for respiratory symptom was required in 7 patients and was associated with the narrowest preoperative tracheal diameter (P = .025) and car-diopulmonary bypass time (P = .040) in univariable analysis. The narrowest tracheal diameter of 3.4 mm was identified as a cutoff value for readmission for res-piratory symptom. Freedom from readmission for respiratory symptom was 63.3% at 10 years. Conclusions: PA sling repair without tracheal surgery might be a reasonable surgi-cal option with rare need for tracheal intervention. Hospital readmissions for res-piratory symptoms are more frequently required in patients with smaller tracheal diameter and all readmissions were limited to within 2 years after repair. (J Thorac Cardiovasc Surg 2023;166:317-24)