Bioresorbable Airway Splint Pivotal Clinical Trial

The purpose of this study is to learn if a three-dimensional (3D) printed airway splint device made to hold open a collapsing airway is a safe and effective treatment of Tracheobronchomalacia (TBM) in children.

The airway splint is bioresorbable, meaning the child's body will absorb the splint over about five years.

Other sites will be added to the registration as sites are on-boarded.

Eligibility Criteria:
Inclusion Criteria:

* Subject must have clinically significant tracheobronchomalacia and:

  1. be unable to wean off of mechanical ventilation, and/or
  2. be currently dependent on a tracheostomy tube, and/or
  3. meet current indications for a tracheostomy or another surgical intervention for TBM
* Subjects must have a life expectancy of at least 2 years, exclusive of TBM
* Subjects must have a parent or legal guardian capable of giving consent on behalf of the subject, and must be willing and able to complete the requirements of clinical trial follow-up
* Subject must have a physician willing to provide follow-up clinical data, including a bronchoscopy at 2 years
* Subjects must be greater than 1 week of age and less than 4 years of age. (Infant subjects born preterm, with low birth weight, or small for gestational age are eligible for trial enrollment if their comorbidities do not present a contraindication to surgical intervention for subjects TBM and airways are of a size that can appropriately be treated with the range of splint sizes offered in this clinical trial)

Patency-Based Pre-Operative Inclusion Criteria:

- Subjects must have tracheobronchomalacia in the trachea, left main bronchus, or right main bronchus a minimum patency of less than 50% in one of these regions

* Screening: In order for a subject to be sent to a clinical trial site for evaluation for the clinical trial, a subject must have tracheobronchomalacia with evidence of less than 50% minimum patency based on a Computed Tomography Scan (CT), Magnetic resonance imaging (MRI), or bronchoscopic exam at referring institution confirmed by an imaging or operative note from the local physician.
* At Enrollment: The subject must have tracheobronchomalacia with minimum patency of less than 50% in the trachea and/or left mainstem bronchus and/or right mainstem bronchus, based on expiration/inspiration CT performed at a clinical trial site performed during visit 1

Intra-Operative Inclusion Criteria:

- The surgeon can safely dissect out the malacic trachea or bronchus/bronchi in order to place the splint

Pre-Operative Exclusion Criteria:

* Subject has significant fixed anatomic tracheal stenosis
* Subject has untreated complete tracheal rings
* Subject has single-lung anatomy
* Subject has single-ventricle cardiac anatomy
* Subject has external compression due to active malignancy, active infection, or an undrained cyst
* Subject has a non-bioresorbable airway stent. Recent removal of any stent will require verification of integrity of the airway wall
* Subject has a contraindication to surgery other than airway compromise
* Subject has a known hypersensitivity to polycaprolactone or hydroxyapatite, and/or a previous unusual reaction to bioresorbable sutures
* Subject has a genetic defect of cartilage formation
* Subject has significant bronchomalacia distal to the mainstem as the predominant source of subject's airway obstruction
* Membranous posterior wall intrusion is the predominant form of collapse