Current evidence on the safety and efficacy of thoracoscopic aortopexy for severe primary tracheomalacia is limited to small case series and reports. Therefore, clinicians wishing to undertake this procedure should make special arrangements for clinical governance, consent and for audit or research.
Clinicians wishing to undertake thoracoscopic aortopexy for severe primary tracheomalacia should take the following actions.
Inform the clinical governance leads in their Trusts.
Ensure that parents or carers understand the uncertainty about the procedure's safety and efficacy. They should explain the alternative management options and the likely need for additional treatments. They should provide parents or carers with clear, written information. Use of NICE's information for the public is recommended.
Audit and review clinical outcomes of all patients having thoracoscopic aortopexy for severe primary tracheomalacia (see section 3.1).
Patient selection and treatment should be carried out by a multidisciplinary team, which should include a surgeon experienced in paediatric thoracoscopic procedures (see also section 2.5).