ABSTRACT
Tracheomalacia is the abnormal collapse of the tracheal lumen and is common after cardiac compression. In the severe types, tracheomalacia can lead to significant morbidity, especially if encountered in a critical area, such as the distal part of the trachea, immediately above the tracheal bifurcation. We report a case that did not improve after cardiac surgery with persistent airway narrowing of more than 90%, requiring ventilatory support for a year. The case was difficult to manage, but the patient eventually showed a significant improvement after a posterior aortopexy that helped a lot in weaning him off the ventilator with a residual persistent audible wheeze and recurrent chest exacerbation. The diagnostic and therapeutic options for the case will be discussed