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Aberrant right subclavian artery intervention can provide relief of dysphagia

Cathlyn K Medina1, John A Kucera1, Berk Aykut1

  • 1Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, NC, USA.

Cardiology in the Young
|October 9, 2024
PubMed

Insights

Aberrant right subclavian artery (ARSA) can rarely cause severe dysphagia in children. Surgical correction through subclavian reimplantation effectively resolved swallowing difficulties and improved weight gain in a small patient cohort.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Surgery
  • Vascular Anomalies

Background:

  • Aberrant right subclavian artery (ARSA) is the most common aortic arch vascular anomaly.
  • Traditionally, ARSA is not considered a cause of dysphagia.
  • This study challenges conventional wisdom by presenting cases where ARSA caused significant swallowing issues.

Purpose of the Study:

  • To investigate the potential link between ARSA and dysphagia in pediatric patients.
  • To present a series of cases where ARSA was the cause of debilitating dysphagia.
  • To evaluate the efficacy of surgical intervention for ARSA-induced dysphagia.

Main Methods:

  • A cohort of four children with dysphagia attributed to ARSA was studied.
  • Surgical intervention involved subclavian reimplantation.
  • The surgical approach utilized was a right posterolateral thoracotomy.

Main Results:

  • All four patients experienced complete resolution of dysphagia postoperatively.
  • Patients were able to transition to a normal diet and achieve appropriate weight gain.
  • Clinical follow-up indicated sustained positive outcomes.

Conclusions:

  • ARSA should be considered a rare but potential cause of dysphagia in children.
  • Surgical management, specifically subclavian reimplantation, can lead to dramatic symptom resolution.
  • This case series highlights the importance of considering ARSA in the differential diagnosis of pediatric dysphagia.
Abstract

Keywords:
Vascular ringdysphagiaoesophaguspaediatricquality of life

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