Multidisciplinary Team Performs UVA Health Children’s First Open Laryngeal Cleft Repair

Ariana Greenwell, MD, assistant professor in the Department of Otolaryngology, Division of Pediatric Otolarynology, and Vanessa Torrecillas, MD, assistant professor in the Department of Otolaryngology, Division of Laryngology, recently performed UVA’s first open laryngeal cleft repair, marking a significant advance in the treatment of complex airway and esophageal disorders at UVA Health Children’s.

A type three laryngeal cleft is one of the more severe forms of tracheoesophageal clefts where the back wall of the trachea and the front wall of the esophagus fail to form, leading to one large cavity and significant breathing and swallowing dysfunction. The repair, which is only performed at a few children’s hospitals throughout the country, was completed successfully with the assistance of a multidisciplinary team.

Typically performed under cardiac bypass, an open laryngeal cleft repair is a challenging surgery with high morbidity. Under the leadership of Lily Cheng, MD, assistant professor in the Department of Surgery, Division of Pediatric Surgery, the team determined during preoperative planning that peripheral veno-venous extracorporeal membrane oxygentation (ECMO) could be used, saving the patient the added morbidity associated with cardiac bypass.

The Pediatric High Risk OR Team, led by Heather Parr, RN, and Kayla Douglas, CST, was instrumental in organizing the day and coordinating three separate surgeries by Drs. Greenwell, Torrecillas, Cheng, and Keith Bachmann, MD, associate professor in the Department of Orthopaedic Surgery, Division of Pediatrics. The patient was kept safe throughout the procedure by senior ECMO perfusionist Dustin Money and anesthesiologist George Politis, MD.

This surgery represents the first pediatric airway reconstruction performed on ECMO at UVA, an exciting innovation that allows UVA Health Children’s to advance care outcomes for our littlest patients.

 

Filed Under: Clinical