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Pediatric airway compression in aortic arch malformations: a multidisciplinary approach

Francesca Petreschi1, Antonella Coretti1, Federica Porcaro1

  • 1Pediatric Pulmonology and Cystic Fibrosis Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Frontiers in Pediatrics
|August 7, 2023
PubMed

Insights

Aortic arch malformations (AAMs) in children often present with respiratory issues. Management strategies vary, with surgery indicated for severe cases, while conservative approaches suit milder conditions.

Area of Science:

  • Pediatric Cardiology
  • Thoracic Surgery
  • Medical Diagnostics

Background:

  • Aortic arch malformations (AAMs) require clinical suspicion in pediatric patients with persistent respiratory symptoms or feeding difficulties.
  • Early identification is crucial for timely intervention and improved outcomes.

Purpose of the Study:

  • To describe a cohort of patients diagnosed with AAMs.
  • To evaluate the effectiveness of a local management protocol for AAMs.
  • To analyze the different types of AAMs and their associated symptoms.

Main Methods:

  • Retrospective review of 59 patients diagnosed with AAMs.
  • Classification into three groups: double aortic arch (DAA), complete vascular ring (non-DAA), and anomalous origin of the innominate artery (IA).
  • Analysis of clinical presentation, diagnostic methods, and treatment outcomes.

Main Results:

  • Prenatal diagnosis was achieved in 62.7% of cases.
  • Nearly half (49.2%) of the children presented with symptoms.
  • Respiratory symptoms varied significantly across groups (73.7% in DAA, 24.2% in non-DAA, 100% in IA).
  • Surgical repair was performed in 52.5% of patients, with symptom improvement observed post-operatively.

Conclusions:

  • Current management protocols for AAMs lack standardization.
  • Conservative management is viable for asymptomatic patients or those with less than 50% airway stenosis.
  • Close patient follow-up is essential for early detection of symptom progression.
Abstract

Keywords:
airway compressionaortic arch malformationsstridorsurgical treatmenttracheomalacia

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