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Diagnosis of the double aortic arch and its differentiation from the conotruncal malformations

Meng-Luen Lee1

  • 1Department of Pediatrics, Division of Pediatric Cardiology, Changhua Christian Hospital, No. 135 Nanhsiao St., Changhua, Taiwan. ferdielee@yahoo.com

Yonsei Medical Journal
|October 30, 2007
PubMed

Insights

Double aortic arch (DAA) in infants causes choking and respiratory distress. Imaging like echocardiography and MRI can diagnose DAA and distinguish it from conotruncal malformations (CTM).

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease
  • Diagnostic Imaging

Background:

  • Double aortic arch (DAA) is a rare congenital heart disease.
  • Differentiating DAA from conotruncal malformations (CTM) is crucial for appropriate management.
  • Pediatric practitioners require familiarization with the clinical and radiological features of these conditions.

Purpose of the Study:

  • To describe the clinical and radiological characteristics of double aortic arch (DAA).
  • To differentiate DAA from conotruncal malformations (CTM) in pediatric patients.
  • To aid pediatric practitioners in diagnosing these congenital heart diseases.

Main Methods:

  • Retrospective study of 6 patients with DAA and 38 patients with CTM (d-TGA, HTA, TA, APW).
  • Utilized chart review, radiography, barium esophagography, echocardiography, cardiac catheterization, angiography, MRI, and chromosome analysis.
  • Excluded incomplete vascular rings and right aortic arch with left ligamentum.

Main Results:

  • All DAA patients presented with postprandial choking and respiratory distress; one had heart failure, none had cyanosis.
  • Esophagograms revealed indentations in 5 DAA patients.
  • CTM patients commonly presented with cyanosis and/or heart failure; echocardiography and angiography were key diagnostic tools.

Conclusions:

  • Barium esophagograms can suggest DAA in neonates with choking and respiratory distress.
  • Echocardiography, angiography, and MRI are effective for diagnosing DAA and differentiating it from CTM.
Abstract

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