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. 2023 Feb;165(2):518-525.
doi: 10.1016/j.jtcvs.2022.05.037. Epub 2022 Jun 8.

Tracheobronchoplasty yields long-term anatomy, function, and quality of life improvement for patients with severe excessive central airway collapse

Daniel H Buitrago  1 , Adnan Majid  1 , Jennifer L Wilson  1 , Daniel Ospina-Delgado  1 , Fayez Kheir  1 , Abraham F Bezuidenhout  2 , Mihir S Parikh  1 , Alex C Chee  1 , Diana Litmanovich  2 , Sidhu P Gangadharan  3
Affiliations
Free article

Tracheobronchoplasty yields long-term anatomy, function, and quality of life improvement for patients with severe excessive central airway collapse

Daniel H Buitrago et al. J Thorac Cardiovasc Surg. 2023 Feb.
Free article

Abstract

Objectives: This study examines the long-term anatomic and clinical effects of tracheobronchoplasty in severe excessive central airway collapse.

Methods: Included patients underwent tracheobronchoplasty for excessive central airway collapse (2002-2016). The cross-sectional area of main airways on dynamic airway computed tomography was measured before and after tracheobronchoplasty. Expiratory collapse was calculated as the difference between inspiratory and expiratory cross-sectional area divided by inspiratory cross-sectional area ×100. The primary outcome was improvement in the percentage of expiratory collapse in years 1, 2, and 5 post-tracheobronchoplasty. Secondary outcomes included mean response profile for the 6-minute walk test, Cough-Specific Quality of Life Questionnaire, Karnofsky Performance Status score, and St George Respiratory Questionnaire. Repeated-measures analysis of variance was used for statistical analyses.

Results: The cohort included 61 patients with complete radiological follow-up at years 1, 2, and 5 post-tracheobronchoplasty. A significant linear decrease in the percentage of expiratory collapsibility of the central airways after tracheobronchoplasty was present. Anatomic repair durability was preserved 5 years after tracheobronchoplasty, with decrease in percentage of expiratory airway collapse up to 40% and 30% at years 1 and 2, respectively. The St George Respiratory Questionnaire (74.7 vs 41.8%, P < .001) and Cough-Specific Quality of Life Questionnaire (78 vs 47, P < .001) demonstrated significant improvement at year 5 compared with baseline. Similar results were observed in the 6-minute walk test (1079 vs 1268 ft, P < .001) and Karnofsky score (57 vs 82, P < .001).

Conclusions: Tracheobronchoplasty has durable effects on airway anatomy, functional status, and quality of life in carefully selected patients with severe excessive central airway collapse.

Keywords: excessive central airway collapse; excessive dynamic airway collapse; quality of life; tracheobronchomalacia; tracheobronchoplasty.

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