The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on thoracoscopic aortopexy for severe primary tracheomalacia in December 2007. In accordance with the Interventional Procedures Programme Process Guide, guidance on procedures with special arrangements are reviewed 3 years after publication and the procedure is reassessed if important new evidence is available.

The guidance was considered for reassessment in February 2011 and it was concluded that NICE will not be updating this guidance at this stage. However, if you believe there is new evidence which should warrant a review of our guidance, please contact us via the email address below.


Tracheomalacia is a weakness and floppiness of the main airway (the trachea) and may cause breathing difficulties. It usually presents at birth but may develop later in life. Aortopexy involves attaching the aorta to the sternum with sutures. This pulls the front wall of the trachea forwards to prevent it from collapsing. The thoracoscopic procedure is performed using special instruments inserted through several small incisions in the chest and with the help of a camera ('keyhole' surgery).

Coding recommendations

L25.8 Other specified other open operations on aorta

Y74.2 Thoracoscopic approach to thoracic cavity NEC

Note: OPCS-4 codes B18.9 Unspecified excision of thymus gland and Y05.2 Partial excision of organ NOC are assigned in addition if part of the thymus gland is excised.

This would also be recorded with the ICD-10 code Q32.0 Congenital tracheomalacia.