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[Double aortic arch: report of one case].

S H Huang, H A Kao, T C Sung

    Zhonghua Minguo Xiao Er Ke Yi Xue Hui Za Zhi [Journal]. Zhonghua Minguo Xiao Er Ke Yi Xue Hui
    |July 1, 1989
    PubMed
    Summary

    A rare congenital vascular anomaly, double aortic arch, can cause severe respiratory distress in infants. Surgical division of the smaller arch effectively relieves tracheal compression and resolves symptoms.

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    Area of Science:

    • Cardiology
    • Pediatric Surgery
    • Medical Imaging

    Background:

    • Double aortic arch is a rare congenital vascular anomaly where the aorta forms two arches.
    • This condition can lead to significant compression of the trachea and esophagus, causing respiratory and feeding difficulties in infants.

    Observation:

    • An 11-month-old male presented with persistent stridor, recurrent respiratory infections, and dyspnea since birth.
    • Symptoms worsened, necessitating intubation and mechanical ventilation due to severe respiratory obstruction and cyanosis.
    • Diagnostic imaging, including bronchogram, esophagogram, and cardiac catheterization, confirmed the presence of a double aortic arch.

    Findings:

    • Surgical intervention via left thoracotomy involved dividing the smaller left arch and the ligamentum arteriosum.
    • This procedure successfully relieved the extrinsic compression of the trachea by the vascular ring.
    • The patient experienced a normal postoperative recovery with resolution of symptoms.

    Implications:

    • Double aortic arch presents with variable symptoms, from mild to life-threatening airway obstruction.
    • Characteristic findings include inspiratory stridor and dyspnea, often exacerbated by feeding or infections.
    • Esophagography is crucial for diagnosis, and surgical division of the anomalous arch offers the definitive treatment.

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