33800 Aortic suspension (aortopexy) for tracheal decompression (eg, for tracheomalacia) (separate procedure)

Name of the Procedure:

Aortic Suspension (Aortopexy) for Tracheal Decompression (e.g., for Tracheomalacia) (Separate Procedure)

Summary

Aortic suspension, also known as aortopexy, is a surgical procedure that aims to relieve pressure on the trachea (windpipe) by repositioning the aorta. This helps improve breathing difficulties in patients with tracheomalacia, a condition characterized by the weakening of the tracheal walls.

Purpose

Medical Condition:

Tracheomalacia

Goals:

• To alleviate airway obstruction and improve breathing.
• To prevent recurrent respiratory infections often associated with tracheomalacia.

Indications

• Persistent breathing difficulties due to tracheomalacia.
• Recurrent respiratory infections.
• Ineffective non-surgical treatments.
• Diagnosis confirmed by imaging or endoscopy showing tracheal compression by the aorta.

Preparation

• Fasting for at least 6-8 hours before the procedure.
• Medication adjustments as directed by the doctor.
• Pre-operative imaging (e.g., CT scan, MRI) and bronchoscopy to assess tracheal compression.
• Pre-anesthetic evaluation to ensure patient’s suitability for surgery.

Procedure Description

1. Anesthesia is administered to ensure the patient is asleep and pain-free.
2. A surgical incision is made in the chest to access the aorta.
3. The aorta is carefully mobilized and repositioned anteriorly (towards the front).
4. Sutures or other surgical devices are used to secure the aorta to the sternum or another stable structure to maintain its new position.
5. The incision is closed, and the surgery site is bandaged.

Tools and Technology:

• Surgical instruments for thoracic surgery.
• Sutures or surgical fixation devices.
• Imaging guidance tools if necessary.
• General anesthesia.

Duration

The procedure typically takes 1-3 hours.

Setting

Performed in a hospital’s operating room or a specialized surgical center.

Personnel

• Thoracic surgeon or cardiovascular surgeon.
• Anesthesiologist.
• Surgical nurses.
• Surgical technologist.

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma formation.
• Injury to surrounding organs or tissues.
• Respiratory complications.
• Blood clots.
• Anesthesia-related risks.

Benefits

• Relief from tracheal compression, leading to improved breathing.
• Reduction in frequency and severity of respiratory infections.
• Overall enhancement in the quality of life soon after recovery.

Recovery

• Hospital stay of 3-7 days for monitoring and initial recovery.
• Pain management with medications.
• Instructions for wound care and activity restrictions.
• Follow-up appointments to monitor recovery.
• Typically, a full recovery may take several weeks to months.

Alternatives

• Continuous Positive Airway Pressure (CPAP) therapy.
• Non-invasive respiratory support.
• Observation and symptomatic management in mild cases.
• Tracheostomy in severe cases where other treatments are ineffective. ##### Pros and Cons:
• Non-surgical options may offer temporary or limited relief.
• Aortopexy provides a more permanent resolution but entails surgical risks.

Patient Experience

• Patients will be asleep and pain-free during the procedure due to anesthesia.
• Post-surgery, there may be some pain and discomfort managed with pain relief medications.
• Gradual improvement in breathing function.
• Monitoring for any immediate complications during the hospital stay.
• Likely to experience gradual return to normal activities over several weeks.