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[Double aortic arch associated with severe left ventricular dysfunction--a case report].

T M Wang1, C W Chen, K S Hsieh

  • 1Section of Pediatrics, Veterans General Hospital-Taichung.

Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|November 1, 1991
PubMed
Summary
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A rare case of double aortic arch in an infant successfully treated with surgical division of the left arch and ligamentum arteriosum, relieving tracheal compression. The infant showed good recovery, though persistent left ventricular dysfunction was noted.

Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Congenital Heart Disease

Background:

  • Double aortic arch is a rare congenital anomaly causing vascular rings that can compress the trachea and esophagus.
  • Severe left ventricular (LV) dysfunction in infants can be associated with complex congenital heart defects.

Observation:

  • A 3-month-old male infant presented with severe LV dysfunction and a complete double aortic arch.
  • The right aortic arch was dominant and retroesophageal, with the left arch forming the descending aorta.
  • The infant experienced respiratory distress due to tracheal compression by the vascular ring.

Findings:

  • Surgical division of the smaller left arch and the ligamentum arteriosum was performed via left thoracotomy.
  • Postoperative recovery was good, with resolution of respiratory symptoms.

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  • Significant improvement in heart failure signs was observed, although severe LV dysfunction persisted at 9-month follow-up.

    • Implications:

    • Surgical intervention for double aortic arch can effectively relieve airway obstruction in infants.
    • Persistent LV dysfunction may require ongoing management even after successful vascular ring decompression.
    • This case highlights the importance of early diagnosis and surgical management of vascular rings in infants with cardiac compromise.