Background and Goal of study. Airway complications in operated children with congenital heart disease (CHD) leads to serious difficulties  in  anesthetic management and postoperative intensive care. We  performed  retrospective study of 8-year management experience of patients  with CHD, complicated by airway problems (compressions, malacia).
Material and Methods. From 2008 till 2015 year in our clinic there were operated 8726 children with CHD. From this group we separated patients with airways obstruction detected with the fiber-optic bronchoscope before, during or after performed cardiac surgery. We estimated the presence and severity of airways compression or tracheobrochomalacia. That represented a study group, that was compared with the patients that had not  airway complications. Demographic data, time of mechanical ventilation and ICU stay, 30-day mortality were calculated as the median and compared with Mann-Whitney U test.
Results and discussion. Study group consisted of 103 patients, who had disorder of airway patency. That represented 1,4% off all our operated patients. Perioperative  and anesthetic management of these patient was performed with due to consideration for their condition and cardiac disease . 71 patient (69%) had different amount narrowing of trachea or bronchi. 32 patients (31%) had sings of tracheobronchomalacia.  Control group consisted of 8623 patients (98,6%), who had not such concomitant problems during perioperative period. Median time of ICU stay in study group was 12 days, whereas in control group it was 3 days (p<0,05). Median time of respiratory support for study group was 68 hours, that was significantly longer then analogous time for the patients without airway narrowing-11 hours (p<0,05). The mortality rate in study group was 7,7 %, while this rate for all pediatric patients operated last 8 years in our clinic was 1,4% (p<0,05).
Conclusion. Airways compression and tracheobronchomalacia in patients with CHD can complicate their postoperative period significantly. Airway complications lead to prolonged time of mechanical ventilation and time of ICU stay. Fiber-optic examination of the airways can be useful in selected cases. Our position is to provide more accurate respiratory system assessment in those patients whom are expected concomitant airways compressions.

Airway complications in paediatric patients with congenital heart disease