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Revista de cirugía

versión impresa ISSN 2452-4557versión On-line ISSN 2452-4549

Resumen

GONZALEZ L., Roberto et al. Complete vascular ring by double symmetrical aortic arch, an infrequent cardiovascular malformation. Rev. cir. [online]. 2019, vol.71, n.1, pp.66-69. ISSN 2452-4557.  http://dx.doi.org/10.4067/S2452-45492019000100066.

Introduction:

The double aortic arch (DAA) is an uncommon cardiovascular malformation, characterized by the persistence of both aortic arches after birth. It can be presented with right dominant branch (70-73%), left or symmetrical. It's anatomical shape produces compression of mediastinal structures such as the trachea and esophagus.

Clinic case:

Infant man 3 months old, with a history of stridor since birth. He was admitted to our center due to severe pneumonia with the need for prolonged mechanical ventilation. Evaluated by otorhinolaryngology, who performed airway revision observing stenosis in the last 5 tracheal rings with dynamic trachea collapse. Chest computed tomography showed complete DAA with emergence of supraaortic trunks of both arches symmetrically. Surgical treatment was decided as soon as possible. It was approached by left anterolateral thoracotomy, vascular control and left aortic arch section distal to subclavian emergency was performed, with aortic and left subclavian artery plasty, aortic arch was released to perform pexia and dissection of fibrotic tissue surrounding the trachea and esophagus. Patient evolved favorably, with resolution of respiratory symptoms and absence of stridor. Postoperative fiberoptic bronchoscopy did not observe tracheal compression. He was discharged on the 14th postoperative day. Currently at six months of follow-up, he is asymptomatic respiratory and cardiovascular.

Discussion:

AAD can affect 0.03% of the pediatric population. It is usually symptomatic with obstructive manifestations such as stridor or dysphagia due to compression of mediastinal structures, which requires high clinical suspicion for its imaging confirmation and subsequent surgical treatment.

Palabras clave : aortopathies; aortic arch; thoracic surgery.

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