Treatment Options in Airway Obstruction in Congenital Heart Disease: Stents and Splints

Patients with pediatric congenital heart disease (CHD) have high rates of concomitant airway obstruction most commonly manifesting as tracheobronchomalacia. These patients airways can be difficult to manage and have traditionally been managed by positive pressure and tracheostomy. Options for management have evolved with airway stenting and splinting providing viable treatment options in this population. The field of airway stenting has evolved with time, moving from non-bioabsorbable stents, metal, and silicone to bioabsorbable stents. These bioabsorbable stents have moved into the pediatric population and have offered the ability to treat tracheobronchomalacia in CHD with the goal to get to definitive treatment often. Beyond stenting, a role for external airway reinforcement has been developed with recent advances in bioabsorbable splints. Three-dimensional (3D) printing has played a crucial role in the success of the external airway splints. Evolution in the fields of endoluminal stenting and external airway splinting has improved the treatment of airway obstruction associated with CHD. Advances in materials and 3D printing have allowed for greater success with reduced complications.