Related Experiment Videos
Insights
Diagnosis of double aortic arch in children is best confirmed with angiography. This vascular anomaly can cause severe respiratory distress and dysphagia, often requiring surgical intervention for symptom resolution.
Area of Science:
- Cardiology
- Pediatric Surgery
- Medical Imaging
Background:
- Double aortic arch is a rare congenital vascular anomaly.
- It can lead to significant airway compression and feeding difficulties in infants and children.
Purpose of the Study:
- To evaluate the diagnostic accuracy of angiography in identifying double aortic arch.
- To describe the clinical presentation and surgical outcomes of children with this condition.
Main Methods:
- Retrospective review of six pediatric cases diagnosed with double aortic arch.
- Diagnostic methods included oesophagography and angiography, with angiography performed via right heart catheterization.
Main Results:
- Angiography confirmed double aortic arch in all six patients.
- Five patients had a right-sided descending aorta with a hypoplastic, stenotic left arch.
- One patient had a left-sided descending aorta with equal arch sizes. Symptomatic presentation included severe inspiratory stridor and dysphagia. Surgical intervention was required for most symptomatic cases, with variable outcomes.
Conclusions:
- Angiography is a highly effective diagnostic tool for double aortic arch.
- Early diagnosis and surgical management are crucial for improving outcomes in symptomatic children.
- The anatomical variations of double aortic arch influence clinical presentation and management strategies.
Abstract:
The diagnosis of double aortic arch was suspected by oesophagography and subsequently proven by angiography in six children. The patients' age ranged from 14 days to 13 years. The diagnostic value of angiography in establishing the existence of two aortic arches is emphasized, which can easily be performed by right heart catheterization. In five patients the aorta descended to the right of the spine; the left arch was hypoplastic and became stenotic or atretic distal to the subclavian artery. In only one case the aorta descended on the left side. In this case both arches had approximately the same size. Four patients were symptomatic immediately after birth and presented with severe inspiratory stridor. The clinical course was so dramatic that surgery was inevitable at the age of four weeks, at 4, 6 and 7 months respectively. The youngest patient died postoperatively. In the other infants the stridor disappeared only months after surgery. One girl had a stridorous respiration occasionally during infancy, later on she complained of dysphagia. She was operated on at the age of 13 years. The double aortic arch was an incidental finding in a girl of 8 years; surgery was not performed.