The surgical repair of a tracheoesophageal fistula combined with the double aortic arch

Introduction: Double aortic arch is a rare congenital malformation of the aortic arch that most frequently presents in childhood. Early surgical intervention typically yields excellent outcomes. Objectives: To describe aortotracheal fistula as a rare, yet serious complication of vascular ring and subsequent aortic aneurysm in an adult patient. Methods: Clinical history, as well as radiographic and endoscopic imaging were obtained to describe the development, diagnosis, and clinical course of this patient’s aortotracheal fistula. Additionally, follow up data was obtained to document the healing of this fistula after surgical repair. Results: We describe a case of a 46-year-old male with DiGeorge Syndrome and a double aortic arch, repaired in childhood, which developed into an aortotracheal fistula after tracheostomy placement as an adult. Conclusions: This case demonstrates that dangerous complications of a double aortic arch can persist into adulthood, even after surgical repair in infancy. Each patient’s unique anatomy must be considered when thinking about airway management and prevention of complications of this rare congenital anomaly.

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Surgical Repair of Double Aortic Arch: 16-Year Experience

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230501300102 ◽

2005 ◽

Vol 13 (1) ◽

pp. 4-10 ◽

Cited By ~ 16

Author(s):

Ganesh Shanmugam ◽

Kenneth Macarthur ◽

James Pollock

Keyword(s):

Aortic Arch ◽

Surgical Repair ◽

Surgical Complication ◽

Vascular Ring ◽

Symptomatic Relief ◽

Median Sternotomy ◽

High Risk Group ◽

Double Aortic Arch ◽

Long Term Results ◽

Persistent Symptoms

Double aortic arch (DAA) is a complete form of vascular ring causing tracheoesophageal compression. We analyzed long-term results of a series of DAAs, over a period of 16 years. Between 1987 and 2003, 29 children underwent surgery for airway and/or esophageal compression secondary to a DAA. Dominant symptoms were stridor, dysphagia, choking episodes, and life-threatening apneic spells ( n = 7). Diagnosis was established by barium studies, bronchoscopy, echocardiogram, angiogram, computed tomography (CT), and magnetic resonance imaging (MRI). Seven patients had concurrent cardiac anomalies. Two children had an associated tracheoesophageal fistula. Surgery was accomplished by left thoracotomy ( n = 25), right thoracotomy ( n = 2) or median sternotomy ( n = 2). The operative mortality was zero. There was one late death due to respiratory failure. Four (13.8%) patients had a surgical complication (chylothorax, 3 cases; acute renal failure, 1 case). Follow-up (mean 7.1 years; range 6 months to 16 years) was complete in all patients, and showed complete improvement in 22 patients and partial improvement in 6 patients. Early surgical repair of DAA is associated with low mortality, and results in marked symptomatic relief in most patients. Patients with tracheomalacia or associated asthma, constitute a high-risk group and may manifest persistent symptoms and require adjunctive procedures.

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Double aortic arch in a newborn with congenital diaphragmatic hernia and tracheoesophageal fistula

Cardiology in the Young ◽

10.1017/s104795111400064x ◽

2014 ◽

Vol 24 (4) ◽

pp. 725-726

Author(s):

Joanne S. Chiu ◽

Julie Glickstein ◽

Amee Shah

Keyword(s):

Magnetic Resonance Imaging ◽

Congenital Heart Disease ◽

Congenital Diaphragmatic Hernia ◽

Aortic Arch ◽

Diaphragmatic Hernia ◽

Tracheoesophageal Fistula ◽

Congenital Heart ◽

Unusual Case ◽

Double Aortic Arch ◽

Resonance Imaging

AbstractCongenital heart disease is associated with congenital diaphragmatic hernia, but diagnosis by echocardiography can be difficult. We present the unusual case of a patient with a double aortic arch and congenital diaphragmatic hernia diagnosed using cardiac magnetic resonance imaging.

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Common arterial trunk and double aortic arch: a rare association

10.22541/au.162195550.07613106/v1 ◽

2021 ◽

Author(s):

Henry Peralta-Santos ◽

Iris Flores-Sarria ◽

Edgar Ramírez-Marroquín ◽

Juan Calderón-Colmenero ◽

Jorge Cervantes-Salazar

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Aortic Arch ◽

Surgical Repair ◽

Double Aortic Arch ◽

Resonance Imaging ◽

Rare Association ◽

Common Arterial Trunk ◽

Arterial Trunk ◽

Cardiovascular Anomalies

Background: The association of double aortic arch and common arterial trunk is extremely rare. The initial surgical approach depends on the patient’s clinical condition and associated cardiac anomalies. Aim: To report a rare association of common arterial trunk with double aortic arch in a 4-month-old female infant. Methods: description of case of a rare association where double aortic arch was not diagnosed initially, surgical repair was done successfully. Results and conclusions: associated cardiovascular anomalies may have an impact on management and outcome. Magnetic resonance imaging and computed tomography may be useful in assessment of this rare association. Complete repair has favorable outcome.

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