scholarly journals P725 An unexpected direction: a case report of a double aortic arch in an asymptomatic woman in adulthood

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
I Campos ◽  
C Vieira ◽  
N Salome ◽  
V H Pereira ◽  
A Costeira Pereira ◽  
...  
Keyword(s):  
Case Report ◽  
Aortic Arch ◽  
Ct Angiography ◽  
Vascular Ring ◽  
Double Aortic Arch ◽  
Posterior Arch ◽  
Vascular Rings ◽  
Thoracic Ct ◽  
Extrinsic Compression ◽  
The Right

Abstract Introduction Complete vascular rings represent about 0.5-2% of all congenital cardiovascular malformations, with the double aortic arch (DAA) being the most common of the complete vascular rings, causing tracheoesophageal compression. The right (posterior) arch is usually dominant (70%), although the two arches can have the same size (5%). The left (anterior) arch is dominant in only approximately 25% of cases. In most cases, this anomaly is diagnosed during childhood due to symptoms caused by oesophageal or tracheal compression. For this reason, case reports of adults are rare. This report describes a case of a 61-year-old woman with DAA with dominant left arch, diagnosed accidentallyby thoracic CT angiography. Case Report Description A 61 years old woman with a previous story of hypertension and type 1 diabetes presented to the emergency service with dyspnoea and thoracic pain. She also referred a history of intermittent dysphagia and cough with at least 12 years of progression. All the parameters of the physical examination were within normal limits. The electrocardiogram showed a normal sinus rhythm with no evidence of acute ischemia and her blood analyses did not show any abnormalitie. She also performed a thoracic CT angiography, which excluded signs of pulmonary embolism, but revealed a vascular ring suggesting a double aortic arch with permeability in both right and left arches as well as their collaterals. The Cardiac MRI was performed with the purpose of excluding ischemia, confirming the double aortic arch with left dominance. The right arch, posterior to the oesophagus and trachea, and the left arch, in an anterior position, showed an anatomic compression of the oesophagus as well as the proximal trachea, capable of eliciting the symptoms mentioned. Other congenital anomalies were excluded. The echocardiography did not demonstrate any additional cardiac malformation. Endoscopy shows a pulsatile extrinsic compression of the esophagus (aortic ring). The patient is currently being studied and closely monitored in the Cardiology consultation. Discussion The most common type of complete vascular ring is the double aortic arch, which accounts for 70% of the complete rings. In most cases, there are two permeable arches, usually with right dominance (70% of the cases). Rarely, both arches are symmetrical. Symptoms usually appear in the fifth month of life. In most cases, only supportive treatment is required. Conclusion This case illustrates the atypical features of this congenital malformation, namely the diagnosis during adulthood as well as the left dominance. Abstract P725 Figure. A double aortic arch

Double aortic arch: an elusive diagnosis in a child with CHD

2021 ◽  
pp. 1-3
Author(s):  
Mariana Lemos ◽  
Miguel Fogaça da Mata ◽  
Ana Coutinho Santos
Keyword(s):  
Ventricular Septal Defect ◽  
Pulmonary Artery ◽  
Aortic Arch ◽  
Ct Angiography ◽  
Septal Defect ◽  
Vascular Ring ◽  
Pulmonary Atresia ◽  
Double Aortic Arch ◽  
Shunt Surgery

Abstract An 18-month-old male with pulmonary atresia and ventricular septal defect presented with stridor after neonatal systemic-to-pulmonary artery shunt surgery, that persisted on follow-up. CT angiography revealed a vascular ring with balanced double aortic arch.

scholarly journals Complete Vascular Ring Detected by Barium Esophagography

2002 ◽  
Vol 81 (8) ◽  
pp. 554-555 ◽  
Author(s):  
Liam J. Skinner ◽  
Stephanie Ryan ◽  
John D. Russell
Keyword(s):  
Aortic Arch ◽  
Vascular Ring ◽  
Double Aortic Arch ◽  
Vascular Rings ◽  
Barium Esophagography

The diagnosis of a vascular ring can be made on the basis of characteristic findings on barium esophagography. We report a case of a double aortic arch in a 9-month-old girl that was diagnosed in this manner, and we briefly review the anatomic characteristics of vascular rings.

Double aortic arch presenting with a foreign object in the oesophagus: a case report and imaging diagnosis

2017 ◽  
Vol 27 (8) ◽  
pp. 1651-1653
Author(s):  
Xiuzhen Yang ◽  
Jingjing Ye ◽  
Zhan Gao
Keyword(s):  
Aortic Arch ◽  
Ct Angiography ◽  
Subclavian Artery ◽  
Three Dimensional ◽  
Double Aortic Arch ◽  
Foreign Object ◽  
Right Loop ◽  
Dimensional Reconstruction ◽  
History Of ◽  
The Right

AbstractIn this article, we report a rare case of double aortic arch. The case presented initially with a foreign object in the oesophagus. The patient was a 2-year-old boy, who was referred with primary symptoms of tussis (15 days) and emesis (2 days). He had a history of ingesting a coin. Routine chest X-ray indicated a rounded, metal foreign object in the upper oesophagus. A half-Yuan coin was removed by gastroduodenoscopy. Echocardiographic imaging suggested that the patient had double aortic arch, which was subsequently diagnosed by CT angiography with three-dimensional reconstruction. The right subclavian artery arose from the right loop of the double aortic arch. The left subclavian artery as well as left and right common carotid arteries had distinct origins from the left aortic arch. Imaging also indicated atresia of the distal left arch. The patient underwent corrective surgery and made a full recovery. Despite the rarity, double aortic arch should be considered when patients present with a foreign object in the oesophagus. Echocardiography and CT angiography can inform the diagnosis.

Persistent wheezing along with apparent stridor caused by a rare anomaly: double aortic arch

2020 ◽  
pp. 004947552095990
Author(s):  
Şule Gökçe ◽  
Nüsabe Abdullayeva ◽  
Feyza Koç ◽  
Hüseyin Hüdaver Alper
Keyword(s):  
Aortic Arch ◽  
Vascular Ring ◽  
Common Type ◽  
Double Aortic Arch ◽  
Abnormal Development ◽  
Vascular Rings ◽  
Aortic Arch Anomaly ◽  
Rare Anomaly

Vascular rings are rare anomalies that occur as a result of abnormal development of the aortic arch complex, often manifested by signs of tracheo-oesophageal compression during the infant period. A double aortic arch anomaly is the most common type of vascular ring pathology. Here we report a case presenting with wheezing and stridor in a 10-month-old child.

Vascular rings

ESC CardioMed ◽  
2018 ◽  
pp. 805-807
Author(s):  
Robert Yates
Keyword(s):  
Aortic Arch ◽  
Vascular Ring ◽  
Significant Proportion ◽  
Double Aortic Arch ◽  
Schematic Model ◽  
Cardiac Defects ◽  
Ligamentum Arteriosum ◽  
Vascular Rings ◽  
Vascular Structures ◽  
Upper Mediastinum

Vascular rings constitute 2% of all congenital cardiac malformations. Accurate prevalence is difficult to estimate because of the lack of symptoms in a significant proportion of cases. ‘Vascular ring’ refers to a variety of congenital vascular anomalies that encircle (partly or completely) and compress the oesophagus and trachea in the upper mediastinum. The vascular structures are not always patent (i.e. ligamentum arteriosum, atretic segment of aortic arch) but can still cause symptoms. The majority are isolated anomalies but some are associated with additional structural congenital cardiac defects. Most can be understood from the Edwards schematic model of a double aortic arch.

scholarly journals Asymptomatic Double Aortic Arch Accidentally Diagnosed for a Child with T-Cell Lymphoma - Case Report

2018 ◽  
Vol 24 (3) ◽  
pp. 157-160
Author(s):  
Hălmaciu Ioana ◽  
Suciu Bogdan Andrei ◽  
Roşca Sorin ◽  
Nagy Bota Monica Cristina ◽  
Trâmbiţaş Cristian ◽  
...  
Keyword(s):  
Case Report ◽  
T Cell ◽  
Aortic Arch ◽  
Cell Lymphoma ◽  
Heart Defects ◽  
Aortic Ring ◽  
T Cell Lymphoma ◽  
Double Aortic Arch ◽  
Angio Ct ◽  
The Right

Abstract Introduction. Double aortic arch (DAA) represents a vascular malformation generated by the persistence of the right dorsal aorta from the intrauterine life. An aortic ring is formed, that surrounds the trachea and esophagus, resulting in difficulty in breathing and swallowing. Case report. We report the case of a 13 years old male child who was admitted to the pediatric surgery department accusing the presence of a paravertebral subcutaneous lesions. Histopathological result of the excised lesion revealed the presence of peripheral T-cell lymphoma. Examination of computer tomography angiography (Angio-CT) revealed the presence of a complete arterial chain (aortic double arch - DAA) around the trachea and esophagus, without signs of compression. Most cases are diagnosed in the first year of life, the literature reports a few cases of DAA diagnosed late, to the adolescent or adult. Clinically most of the anatomical variants are usually symptomatic especially that are associated with congenital heart defects, including also Fallot tetralogy. Conclusions. Angio-CT is a very useful method in diagnosing arterial or venous malformations, symptomatic or asymptomatic.

scholarly journals Double vascular ring: a case report of double aortic arch and concurrent pulmonary artery sling

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Yoshimi Matsumoto ◽  
Masahiro Kamada ◽  
Naomi Nakagawa ◽  
Yukiko Ishiguchi
Keyword(s):  
Ventricular Septal Defect ◽  
Pulmonary Artery ◽  
Aortic Arch ◽  
Septal Defect ◽  
Ductus Arteriosus ◽  
Vascular Ring ◽  
Vena Cava ◽  
Double Aortic Arch ◽  
Pulmonary Artery Sling ◽  
The Right

Abstract Background Double aortic arch (DAA) and pulmonary artery sling (PAS) are vascular ring formations that present in neonates and infants with symptoms of respiratory stenosis. Case summary The patient was a girl with suspected ventricular septal defect (VSD), right aortic arch (AA), left patent ductus arteriosus, and bilateral superior vena cava (SVC) on foetal echography in the first day of life. The girl was delivered at 40 weeks and 4 days of gestation. Ventricular septal defect, DAA, coarctation of the left AA, and bilateral SVC were diagnosed. Contrast-enhanced computed tomography at Day 16 revealed PAS with concurrent anomalous tracheal branching in addition to DAA. The right A2 segmental artery, which supplies the right upper pulmonary artery, showed abnormal branching from the left pulmonary artery (LPA). At 3 months of age, VSD patching, left AA resection distal to the root of the left subclavian artery, arterial ligament dissection, and LPA replacement were performed. Discussion Pulmonary artery sling coexists with anomalous branching of the trachea and abnormal branching of the right pulmonary artery (RPA). Our patient had an extremely rare case of DAA concurrent with PAS and presented with anomalous tracheal and RPA branching. We were concerned that increased pulmonary blood flow caused by the VSD would exacerbate tracheal displacement. Radical surgery at 3 months of age resulted in good postoperative progress.

Morphology of vascular ring arch anomalies influences prognosis and management

2020 ◽  
pp. archdischild-2020-319388
Author(s):  
Elena Ctori ◽  
Adrian Crucean ◽  
Benjamin Pinkey ◽  
Simon P McGuirk ◽  
Robert H Anderson ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Surgical Intervention ◽  
Longitudinal Research ◽  
Vascular Ring ◽  
Double Aortic Arch ◽  
Vascular Rings ◽  
Aortic Arch Anomaly ◽  
Mri Scans ◽  
History Of ◽  
Kommerell Diverticulum

ObjectiveThis study aimed to explore the anatomical features of aortic arch anomalies associated with vascular rings, hoping to identify those which may increase the risk of symptomatic presentation and surgical intervention.MethodsThis was a retrospective observational study at a single cardiac unit. Individuals diagnosed with an aortic arch anomaly, either isolated or non-isolated, between June 2014 and September 2018 were included. The morphology of the aortic arch was established via analysis of postnatal echocardiography, CT or MRI scans. CT and magnetic resonance studies were evaluated for the presence of a Kommerell diverticulum in those with aberrant vessels. Case notes were reviewed for relevant clinical data.ResultsOf those with aberrant subclavian arteries, 24/79 (30.4%) were shown to have a Kommerell diverticulum. Additional forms of congenital heart disease were present in 133/227 (58.6%) individuals. Surgical division of the vascular ring was performed in 30/227 (13.2%), most commonly in the setting of a double aortic arch (70.8%). In those with aberrant subclavian arteries, no children without a Kommerell diverticulum were referred for surgery. In those with a Kommerell diverticulum confirmed on imaging, 11/24 underwent surgery.ConclusionIndividuals with a double aortic arch, or an aberrant subclavian artery arising from a Kommerell diverticulum, have the highest requirement for surgical intervention, especially in isolated anomalies. These individuals should remain under monitoring. The subjective nature of symptoms remains problematic. Longitudinal research is required further to understand the natural history of vascular rings and how it links to morphology.

scholarly journals A Case Report of Double Aortic Arch, Vascular Ring Associated with Tracheal Stenosis.

2002 ◽  
Vol 31 (6) ◽  
pp. 388-391
Author(s):  
Kazuyuki Daitoku ◽  
Koh Takeuchi ◽  
Hiroyuki Itaya ◽  
Kazuo Itoh ◽  
Ikkoh Ichinoseki ◽  
...  
Keyword(s):  
Case Report ◽  
Aortic Arch ◽  
Tracheal Stenosis ◽  
Vascular Ring ◽  
Double Aortic Arch

Vascular ring surgery – can we do better?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
G Amir ◽  
N Soffair ◽  
G Frenkel ◽  
E Bruckheimer ◽  
E Nachum ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Respiratory Symptoms ◽  
Ductus Arteriosus ◽  
Vascular Ring ◽  
Symptomatic Relief ◽  
Mirror Image ◽  
Vascular Rings ◽  
Number Of Patients ◽  
Age At Surgery

Abstract Background Vascular anomalies of the Aortic arch can cause respiratory symptoms in children due to tracheal compression. Treatment consists of division of the vascular rings, nevertheless data regarding mid- term results is scarce. The purpose of this study was to evaluate clinical results of vascular ring surgery. Methods Between2007–2014, 85 children underwent vascular ring surgery. 51 had Double Aortic Arch (DAA, 60%), 31 Right Arch with Aberrant Subclavian Artery (RAA & ALSA, 36.5%) and 3 had RAA, mirror image branching & left ductus arteriosus (3.5%). Mean age and weight at operation were 12.4±13months and 8.6±4.1 kg respectively. Mid-term follow-up included clinical follow up by a pulmonologist (38 patients, 44.7%) and a telephone questionnaire (71 patients, 83%) performed 57±25.7 months after surgery. Results In most patients, symptomatic relief occurred in less than 6 months (table 1). Mid –term follow up revealed that although most parents described a significant improvement in their child's respiratory symptoms (95%), a significant number of patients described some residual respiratory symptoms (table 2). We did not find any significant association between age at surgery (under 6 month), or vascular ring anatomy (DAA vs. RAA&ASA) and the presence of residual symptoms at follow up Conclusions Surgical division of vascular rings results in a significant clinical improvement within one year, nevertheless many patients remain symptomatic to some degree. We found no association between the age at surgery or anatomic variant to the presence of symptoms in mid- term follow up. Further evaluation whether a more aggressive surgical approach is warranted in order to decrease the incidence long-term symptoms. Funding Acknowledgement Type of funding source: None

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