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A 69-year-old man was admitted to our hospital with progressive dyspnoea accompanied by inspiratory stridor. He presented a history of surgical aortic valve replacement 3 years previously, complicated by prolonged postoperative mechanical ventilation requiring percutaneous tracheostomy. Presently, bronchoscopy evidenced tracheomalacia (TM) with subtotal tracheal stenosis. CT scan confirmed long segment narrowing >20 mm of the upper trachea (figure 1). Operative retracheostomy resulted in repeated tube dislocation …