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For Referring Physicians

Research & Innovation

We are always exploring new ways to better diagnose and treat vascular rings and airway compression. Here are some recent technological and clinical advances as well as some research findings that allow us to create a personalized treatment plan for each patient and perform each surgery safely and with precision.

Creating custom-fitted and better-quality airway stents

Conventional stents placed inside the airway to treat tracheomalacia can slide out of place, prevent the movement of mucus, or get stuck in airway tissue. Our team has designed a new airway stent to better support patients. The stent doesn’t prevent the flow of mucus, is easy to remove, and can be custom-molded to snugly fit a patient’s anatomy.

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Soft stents, hardened in place by UV light, allow a snug, custom fit

An airway stent, custom-fit in real time, could benefit patients with tracheobronchomalacia. The design may be adaptable for heart implants.

Read more

An airway splint that doesn’t go in the airway

As an alternative to an airway stent, our team has devised a technique to custom fabricate a tracheobronchial splint that can hold open a patient’s airway without being placed inside the airway — and the device will be naturally absorbed by the body over time.

Improving the safety of vascular ring surgery

We’re constantly improving how we protect critical nerves during vascular ring operations. One such recent step was changing how we monitor the recurrent laryngeal nerve — which controls the muscles of the voice box. Sometimes, it is difficult to find the nerve in children who have already had surgery in that area. To better track the nerve during an operation, we adapted the technology behind intraoperative nerve monitoring (IONM), a technique that’s used in surgeries that pose a risk to the nervous system. Using IONM, we’re able to precisely identify the recurrent laryngeal nerve’s location and monitor it during vascular ring operations. We also are sure to check vocal cord function before and after surgery to ensure each patient is closely monitored and appropriate follow-up is recommended as needed.

Tracheomalacia and airway symptom study

There are currently no objective means for assessing patients’ tracheobronchomalacia and tracheobronchial compression, nor are there any means for predicting which patients will benefit from surgery and which ones will not. We are aiming to change that by better understanding the diagnosis and management of the condition through a study of patients, with support provided by a grant from the American Association for Thoracic Surgery.

We are enrolling patients who are being considered for surgery on their airway at Boston Children’s in a study to objectively quantify activity before and after the operation. Patients will wear a monitoring device for a week before surgery and a week after surgery to measure overall activity and any sleep disturbances. If your family is interested in participating or if you have questions, please email carmel.falek@childrens.harvard.edu for more information.

Quantifying and tracking patient symptoms

It’s important to have a comprehensive view of the health of children with esophageal and tracheal symptoms. We are developing methods that will give us the ability to measure and track a child’s symptoms before treatment and after an operation. Our hope is that a better understanding of a patient’s condition will improve our ability to identify those who are most likely to benefit from surgery.

Outcomes after thoracotomy or thoracoscopic vascular ring division

We looked at the outcomes of 200 patients who had vascular ring division by video-assisted thoracoscopic (VATS) or a thoracotomy approach. We found that both approaches can be performed with low rates of complication and need for reintervention.

Reoperation to correct unsuccessful vascular ring and vascular decompression surgery

Although most children do well after operations to relieve vascular compression of the esophagus and airway, some will have persistent or recurrent symptoms. We reviewed our surgical experience using a customized approach to correct various etiologies of failure after vascular ring and decompression surgery. We found that a multidisciplinary strategy for workup and a customized operative approach can effectively treat these cases and may suggest an opportunity at the index surgery to prevent reoperation and achieve optimal outcomes.

Publications

2024
  • Izadi S, Chiu P, Baird CW, Zendejas B. Vascular Rings, Pulmonary Artery Slings and Other Tracheal Anomalies. In: Editors. Manual of Neonatal Surgical Intensive Care. 4thed. Pmph USA; 2024.
  • Powell AJ, Sanders SP, Baird CW. Developmental Anomalies of the Aortic Arch and Pulmonary Arteries: Vascular rings, slings and associated lesions. In: Walsh EP, Mayer JE, Teele SA, Brown DW.Nadas’PediatricCardiology.3rd ed. Cambridge(?):Elsevier; 2024.
  • Cole L, Brown J, Yasuda J, Ngo P, Staffa SJ, Crilley N, Chiu P, Zendejas B, Baird C. Left aortic arch and aberrant right subclavian artery in children: spectrum of symptoms and response to surgical intervention. Cardiology in the Young. 2024;1–7. doi:10.1017/S1047951124026519
  • Gikandi A, Chiu P, Crilley N, Brown J, Cole L, Emani S, Fynn Thompson F, Zendejas B, Baird C. Outcomes of Patients Undergoing Surgery for Complete Vascular Rings. J Am Coll Cardiol. 2024 Oct 1;84(14):1279-1292. doi: 10.1016/j.jacc.2024.05.078. PMID: 39322321
2023

September 2023

  • Izadi S, Zendejas B, Meisner J, Kamran A, Mohammed S, Demehri F, Staffa S, Zurakowski D, Hseu A, Cunningham M, Choi S, Barnewolt C. Diagnostic accuracy of laryngeal ultrasound for evaluating vocal fold movement impairment in children. Journal of Pediatric Surgery. 2023 Sep 22;S0022-3468(23)00554-7.

June 2023

  • Chiu P, Zendejas B, Baird C. Multidisciplinary approach to vascular rings and vascular-related aerodigestive compression: a clinical practice review. Transl Pediatr. 2023;12(6):20.

March 2023

  • Meisner JW, Izadi S, Kamran A, Shieh HF, Smithers CJ, Bennett J, Demehri FR, Mohammed S, Lawlor C, Choi SS, Zendejas B. Screening for vocal fold movement impairment in children undergoing esophageal and airway surgery. Laryngoscope. 2023 Mar 9.

Other

  • Chiu P, Zendjeas B, Jennings RW, Baird CW. “Chapter 117: Congenital tracheal disease,” in Sabiston & Spencer: Surgery of the Chest 10th edition, ed. Frank Sellke & Pedro J . del Nido & Scott J. Swanson (Philadelphia: Elsevier, 2023). In Press
2022

April 2022

  • Lawlor CM, Meisner J, Jennings RW, Zendejas B, Choi SS. Comparative effectiv enss of recurrent laryngeal nerve monitoring techniques in pediatric surgery. Laryngoscope. 2022 Apr;132(4)889-894.

March 2022

  • Chiu P, Jennings RW, Friedman KG, Baird CW. Bronchomalacia in Right Aortic Arch Treated With Descending Aortic Translocation and Airway Splint. Ann Thorac Surg 2022;113: e187-e189.
2021

November 2021

  • Carlson L, Haider M, Liu H, Baird C, Mayer JE, Nathan M. Left Pulmonary Artery Sling: Postoperative Outcomes for Patients at a Single Center. World Journal for Pediatric and Congenital Heart Surgery. 2021;12(6):715-727.
  • Labuz DF, Kamran A, Jennings RW, Baird CW. Re-operation to Correct Unsuccessful Vascular Ring and Vascular Decompression Surgery. J Thorac Cardiovasc Surg. 2021 Nov 11: S0022-5223(21)01542-7.

August 2021

  • Chiu, P., Jennings, R. W., Marx, G., Baird, CW. Aortic elongation and bronchial splint for late bronchial complication after neonatal arch reconstruction. JTCVS Tech. 2021 8: 126-128.

June 2021

  • Kamran A, Zendejas B, Jennings  RW. Current concepts in tracheobronchomalacia: Diagnosis and treatment. Seminars in Pediatric Surgery. June 2021; 30(3):151062.
  • Chiu P, Jennings RW, Friedman KG, Baird CW. Bronchomalacia in Right Aortic Arch Treated With Descending Aortic Translocation and Airway Splint. Ann Thorac Surg. 2022 Mar;113(3):e187-e189. doi: 10.1016/j.athoracsur.2021.04.105. Epub 2021 Jun 1. PMID: 34081976.

April 2021

  • Holland M, Schulz A, Feins EN, Baird CW. Neonates with Right Aortic Arch Requiring Arch Reconstruction: A Single-Institution Experience. Ann Thorac Surg. 2021 Apr 14; S0003-4975(21)00696-2.
  • Kamran A, Smithers CJ, Baird CW, Jennings RW, Experience with Bioresorbable Splints for Treatment of Airway Collapse in a Pediatric Population. JTCVS Tech. 2021 Apr 19; 8:160-169.
2020

November 2020

  • Lawlor CM, Zendejas B, Baird C, Munoz-San Julian C, Jennings RW, Choi SS. Intraoperative Recurrent Laryngeal Nerve Monitoring During Pediatric Cardiac and Thoracic Surgery: A Mini Review. Front Pediatr. 2020 Nov 27; 8:587177.

August 2020

  • Svetanoff WJ, Zendejas B, Smithers CJ, Prabhu SP, Baird CW, Jennings RW, Hamilton TE. Great vessel anomalies and their impact on the surgical treatment of tracheobronchomalacia. J Pediatr Surg. 2020 Jul;55(7):1302-1308. doi: 10.1016/j.jpedsurg.2019.08.001. Epub 2019 Aug 6. PMID: 31422856.

May 2020

  • Kamran, A., Friedman, K. G., Jennings, R. W., & Baird, CW. Aortic uncrossing and tracheobronchopexy corrects tracheal compression and tracheobronchomalacia associated with circumflex aortic arch. J Thorac Cardiovasc Surg 2020, 160(3): 796-804.
  • Svetanoff WJ, Zendejas B, Frain L, Visner G, Smithers CJ, Baird CW, Prabhu SP, Jennings RW, Hamilton TE. When to consider a posterolateral descending aortopexy in addition to a posterior tracheopexy for the surgical treatment of symptomatic tracheobronchomalacia. J Pediatr Surg. 2020 May.

February 2020

  • Lawlor C, Smithers CJ, Hamilton T, Baird C, Rahbar R, Choi S, Jennings R. Innovative management of severe tracheobronchomalacia using anterior and posterior tracheobronchopexy. Laryngoscope. 2020 Feb;130(2): E65-E74.

January 2020

  • Kamran A, Baird CW, Jennings RW. Tracheobronchomalacia, Tracheobronchial Compression, and Tracheobronchial Malformations: Diagnostic and Treatment Strategies. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2020; 23:53-61.
2019

September 2019

  • Shieh HF, Smithers CJ, Hamilton TE, Zurakowski D, Visner GA, Manfredi MA, Jennings RW, Baird CW. Descending Aortopexy and Posterior Tracheopexy for Severe Tracheomalacia and Left Mainstem Bronchomalacia. Semin Thorac Cardiovasc Surg. 2019 Autumn; 31(3):479-485.

August 2019

  • Svetanoff WJ, Bairdain S, Smithers CJ, Prabhu S, Baird CW, Jennings RW, Hamilton TE. Incidence of Great Vessel Anomalies in Patients with Esophageal Atresia or Tracheobronchomalacia. J Pediatr Surg. 2019 Aug 6. 

June 2019

  • Kamran A, Maschietto N, Baird CW, Jennings RW. Internal stents and external splints for complex airway obstruction. J Dis Esoph. 2019 Jun; 32: Supp1.

March 2019

  • Lawlor CM, Smithers C, Hamilton T, Baird CW, Rahbar R, Sukgi C, Jennings R. Innovative Management of Severe Tracheobronchomalacia using Anterior and Posterior Tracheobronchopexy. Laryngoscope. 2019 Mar 25.

January 2019

  • Alsaied, T., Friedman, K., Masci, M., Hoganson, D. M., Baird, C. W., & Geva, T. 2018. Type B Interrupted Right Aortic Arch: Diagnostic and Surgical Approaches. Ann Thorac Surg. 2019 Jan;107(1) :e41-e43.
2018

December 2018

  • Kamran A, Hamilton TE, Zendejas B., Nath B., Jennings RW, Smithers CJ. Minimally invasive surgical approach for posterior tracheopexy to treat severe tracheomalcia: Lessons learned from initial case series. J Laparoendosc Adv Surg Tech A. 2018 Dec; 28)12):1525-1530.

January 2018

  • Shieh HF, Smithers CJ, Hamilton TE, Zurakowski D, Visner GA, Manfredi MA, Baird CW, Jennings RW. Posterior tracheopexy for severe tracheomalacia associated with esophageal atresia (EA): Primary treatment at the time of initial EA repair versus secondary treatment. Front Surg. 2018 Jan 15; 4:80.

Other

  • Shieh HF, Smithers CJ, Hamilton TE, Zurakowski D, Visner GA, Manfredi MA, Jennings RW, Baird CW. Descending aortopexy and posterior tracheopexy for severe tracheomalacia and left mainstem bronchomalacia. Semin Thorac Surg. 2018; 31:479-85.
2017

August 2017

  • Herrin M, Baird C, Emani S. Outcomes following thoracotomy or thoracoscopic vascular ring division in children and young adults. J Thorac Cardiovasc Surg. 2017 Aug; 154(2):607-615.

June 2017

  • Shieh HF, Smithers CJ, Hamilton TE, Zurakowski D, Rhein LM, Manfredi MA, Baird CW, Jennings RW. Posterior tracheopexy for severe tracheomalacia. J Ped Surg. 2017 Jun; 52(6):951-955.
  • Shieh H, Smithers CJ, Hamilton TE, Zurakowski D, Visner GA, Manfredi MA, Baird CW, Jennings RW. Posterior tracheopexy for severe tracheomalacia associated with esophageal atresia (EA): Primary treatment at the time of initial EA repair versus secondary treatment. J Pediatr Surg. 2017 Jun; 52(6):951-955.
2016

July 2016

  • Baird CW, Prabhu S, Buchmiller TL, Smithers C, Jennings R. Direct Tracheobronchopexy and Posterior Descending Aortopexy for Severe Left Mainstem Bronchomalacia Associated With Congenital Pulmonary Airway Malformation and Left Circumflex Aortic Arch. Ann Thorac Surg. 2016 Jul;102(1):e1-4. doi: 10.1016/j.athoracsur.2015.11.065. PMID: 27343517.

June 2016

  • Bairdain S, Zurakowski D, Baird CW, Jennings RW. Surgical treatment of tracheobronchomalacia: A novel approach. Paediatr Respir Rev. 2016 Jun;19:16-28.
  • Bairdain S, Foker JE, Smithers CJ, Hamilton TE, Labow BI, Baird CW, Taghinia AH, Feins N, Manfredi M, Jennings RW. Jejunal interposition after failed esophageal atresia repair. J Am Coll Surg. 2016 Jun; 222(6):1001-8.
2015

June 2015

  • Bairdain S, Smithers CJ, Hamilton TE, Zurakowski D, Rhein L, Foker JE, Jennings RW, Baird CW. Direct Tracheobronchopexy to Correct Airway Collapse due to Severe Tracheobronchomalacia: Short term outcomes in a series of 20 patients. J Pediatr Surg. 2015 Jun; 50(6):972-7.