management of double aortic arch in children
نویسندگان
چکیده
objective : double aortic arch (daa) is a rare congenital malformation. strategies for diagnosis and treatment are different. thoracoscopic treatment of daa is limited to case reports or little case series. we report a description of our diagnostic and therapeutic approach and evaluate outcomes. methods: we reviewed charts of infants with double aortic arch who were hospitalized in our department from 2008 to 2014. age at symptom onset, clinical presentation, diagnostic modality, operative details and post operative outcomes were retrieved. results: we identified 7 patients presenting at a median age of 11,8 months (range: 2months-27months) and median weight of 10kg. respiratory symptoms were present in all cases. difficulties in feedings were present in 3 cases. chest radiography, oesophagogram and computed tomography (ct) with three-dimentional (3d) reconstructions were performed for all patients. one patient have had laryngo tracheoscopy and 3 patients echocardiography. the dominant branch was the right one in all cases. associated cardiac anomaly was found in 1case. operative approach was thoracotomy in 3 cases and thoracoscopic video assisted surgery (vats) in 4 cases. median operative time was 132min. only one patient required conversion. median hospital stay was 4,1days. conclusion: double artic arch is a rare malformation which can cause persistent non specific respiratory symptoms in infants. the use of 3d-ct scan reconstruction that facilitate diagnosis and the operative approach. thoracoscopy and thoracotomy are effective procedures even for patients with low weight. the operative time seems similar for both. thoracoscopy offers less post operative analgesia, shorter hospital stay and good cosmetic results.
منابع مشابه
Three Cases of a Rare Association: Double Aortic Arch
Background Vascular ring is less than 1% of congenital heart disease. Double aortic arch (DAA) is the most common form of it. Its detecting is important because of the effects of pressure on the esophagus and trachea. Case Report In this study, three children suffering from double aortic arch with symptoms of dysphagia and recurrent aspiration, which in two cases had led to cardiac arrest, wer...
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In conclusion, the diagnosis of DAA should be suspected in an infant with either biphasic stridor or feeding-related respiratory distress. Radiographic studies combined with appropriate thorough endoscopic evaluation should confirm clinical suspicion. Thoracotomy with surgical division of the DAA has given excellent long-term results.
متن کاملDouble aortic arch.
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متن کاملAsymptomatic double aortic arch
A 51-year-old male patient with a past history of lung tuberculosis was referred to our clinic for routine control. The patient reported no complaints and chest X-ray was normal. Three-dimensional thoracic computed tomography revealed a balanced-type double aortic arch with no compression of trachea or esophagus.
متن کاملAsymptomatic double aortic arch.
chest X-ray film (Fig. 1). Clinical examination was normal. Computed tomographic angiography of the chest (Figs. 2, 3) showed a balanced type of double aortic arch, both of which arose from the ascending aorta anterior to the tracheae. Each arch gave origin to the common carotid and subclavian artery, and joined right posterior ward to form the descending aorta. The patient had neither respirat...
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عنوان ژورنال:
iranian journal of pediatric surgeryجلد ۲، شماره ۱، صفحات ۱۶-۲۰
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