Factors associated with tracheoplasty in children with pulmonary artery sling and congenital tracheal stenosis.

Abstract

The study objective was to investigate the anatomic and clinical factors associated with tracheoplasty in children with pulmonary artery sling and congenital tracheal stenosis. This retrospective multicenter study included children with pulmonary artery sling who underwent surgical treatment at 3 cardiac centers in China between January 2010 and September 2025. Preoperative clinical characteristics, computed tomography measurements, and operative data were reviewed. Univariable and multivariable logistic regression analyses were performed to identify factors independently associated with tracheoplasty. Interaction analyses were also conducted. After excluding 24 patients with incomplete preoperative imaging data, 330 patients with pulmonary artery sling and congenital tracheal stenosis were included. Among them, 302 (91.5%) underwent slide tracheoplasty and 28 (8.5%) underwent pulmonary artery sling correction alone. Younger age, long-segment tracheal stenosis, and more severe airway narrowing were independently associated with a higher frequency of tracheoplasty. Younger age, long-segment tracheal stenosis, and more severe airway narrowing were independently associated with tracheoplasty in this multicenter cohort. Tracheoplasty performance appeared to be influenced by multiple factors rather than any single imaging parameter. Further prospective studies with long-term follow-up are required to evaluate clinical outcomes associated with different management strategies.