Surgery improves tracheal morphology in pediatric pulmonary artery sling cases

This retrospective cohort study evaluated 17 pediatric patients diagnosed with pulmonary artery sling at Fujian Children's Hospital. The intervention was pulmonary artery sling surgery, compared to preoperative status, with primary outcomes focused on quantitative tracheal morphology via CT, including diameter, cross-sectional area, narrow-to-wide ratios (NWR), and carina angles. Postoperative CT follow-up was conducted, though only 12 of the 17 patients underwent this imaging.

Main results showed statistically significant improvements in tracheal metrics. The diameter-based NWR increased from 0.41 ± 0.17 to 0.73 ± 0.12 (p < 0.05), and the area-based NWR increased from 0.22 ± 0.19 to 0.52 ± 0.13 (p < 0.05). Additionally, the tracheal carina angle decreased from 120.32° ± 10.58° to 77.11° ± 10.60° (p < 0.05), indicating morphological changes post-surgery.

Safety and tolerability data were not reported in the study. Key limitations include the small sample size of 17 patients and that only 12 had postoperative CT follow-up, which may affect generalizability and completeness of data. The study relies on CT for quantitative measurements, as noted in practice relevance, but does not address long-term outcomes or causality.

In practice, these findings suggest that surgery may lead to measurable improvements in tracheal structure in this rare condition, but clinicians should consider the observational nature and limited follow-up when applying results. Further research with larger cohorts and comprehensive safety assessments is needed to confirm benefits.