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Operation for aortic arch anomalies

J V Richardson, D B Doty, N P Rossi

    The Annals of Thoracic Surgery
    |May 1, 1981
    PubMed
    Summary
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    Surgical correction of aortic arch anomalies effectively relieves tracheoesophageal compression in infants and children. This study highlights safe and successful treatment for these congenital conditions.

    Area of Science:

    • Cardiology
    • Pediatric Surgery
    • Medical Diagnostics

    Background:

    • Aortic arch anomalies are significant causes of upper respiratory and esophageal obstruction in infants and children.
    • These congenital conditions require timely diagnosis and intervention for optimal outcomes.

    Purpose of the Study:

    • To evaluate the safety and efficacy of surgical correction for aortic arch anomalies causing tracheoesophageal compression.
    • To analyze the types of anomalies, diagnostic methods, surgical principles, and patient outcomes.

    Main Methods:

    • Retrospective review of 42 patients treated for aortic arch anomalies between 1948 and 1978.
    • Diagnosis primarily utilized barium esophagography.
    • Surgical approach involved left thoracotomy with identification and division of the constricting aortic arch segment.

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    Main Results:

    • The most common anomalies were right aortic arch with ligamentum arteriosum (45%) and double aortic arches (40%).
    • Diagnosis was accurate in 90% of patients via barium esophagogram.
    • Surgical treatment had a 5% mortality rate (2 early deaths, 1 late death), with common early postoperative respiratory complications. Survivors experienced excellent long-term symptom relief (median 94 months).

    Conclusions:

    • Surgical correction of aortic arch anomalies causing tracheoesophageal compression is a safe and effective treatment in pediatric patients.
    • Early diagnosis and surgical intervention lead to excellent long-term symptom relief for survivors.
    • Despite potential early respiratory complications, surgical management offers significant benefits for infants and children with these anomalies.