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Airway obstruction by right aortic arch with right-sided patent ductus arteriosus: demonstration by MRI
K K Friese1, M C Dulce, C B Higgins
1Freie Universität Berlin, Universitätsklinikum Steglitz, Germany.
Abstract:
An unusual cause of airway obstruction was demonstrated by MRI in two infants with congenital heart disease. The two infants experienced airway obstruction caused by a right aortic arch with right-sided patent ductus arteriosus. The diagnosis was established by MRI prior to surgery; angiography did not demonstrate the critical relationship between the large ductus and the airway. Axial, sagittal, and coronal MRI displayed the right arch, dilated ductus, and the compression of the proximal right bronchus and distal trachea by the ductus. Surgical findings confirmed the MR diagnosis. Thus, MRI can be used to localize the site of airway obstruction and to demonstrate unusual types of vascular anomalies.
Insights
Magnetic resonance imaging (MRI) identified an unusual cause of airway obstruction in infants with congenital heart disease. This imaging technique precisely located vascular anomalies compressing the airway, aiding surgical planning.
Area of Science:
- Pediatric Cardiology
- Diagnostic Imaging
- Thoracic Surgery
Background:
- Congenital heart disease (CHD) can present with complex airway issues.
- Accurate localization of airway compression is crucial for surgical intervention.
Observation:
- Two infants with CHD experienced airway obstruction due to a right aortic arch and right-sided patent ductus arteriosus.
- Magnetic resonance imaging (MRI) revealed the vascular anomaly compressing the bronchus and trachea.
Findings:
- MRI accurately depicted the right aortic arch and dilated patent ductus arteriosus.
- The imaging demonstrated direct compression of the proximal right bronchus and distal trachea by the ductus.
- Angiography failed to show the critical relationship between the ductus and the airway.
Implications:
- MRI is a valuable tool for diagnosing airway obstruction in infants with CHD.
- This modality can identify unusual vascular anomalies causing extrinsic airway compression.
- Preoperative MRI enhances surgical planning and improves patient outcomes.