Airway Abnormalities in Children Operated for Congenital Heart Disease: Clinical characteristics and risk factors from a case-control study.

Objectives: Congenital heart disease (CHD) is the most common congenital defect, with airway abnormalities (AAs) representing significant comorbidities that contribute to increased morbidity and clinical complexity. This study aimed to identify the most common AAs, associated risk factors, and clinical outcomes in children with CHD. Methods: This case-control study included children aged under 13 years with CHD who underwent cardiothoracic surgery between 1 January 2016 and 31 December 2018 at the National Genetic Centre in Oman. Cases were children with concurrent AAs, while controls were age- and gender-matched children with CHD but without AAs. Results: The prevalence of concomitant AAs in children with CHD in the cohort was 5.5%. The most common AAs were vascular compressions (47.4%), followed by airway malacia (23.1%). Chest computed tomography was the most frequently utilised diagnostic modality. Prematurity was significantly more common among children with AAs (odds ratio: 3.2, 95% confidence interval: 1.1-11.1; P = 0.016), and the duration of invasive ventilation was significantly longer (P = 0.013). Conclusion: AAs are important comorbidities in children with CHD. This study highlights the need for increased clinical vigilance and early investigation of AAs in this population. Prospective studies are warranted to further assess the long-term implications of these findings.