SYMPTOMATIC ANOMALIES OF AORTIC-ARCH

  • 1 January 1978
    • journal article
    • research article
    • Vol. 147  (5) , 673-681
Abstract
Patients (28) with anomalies of the aortic arch producing compression of the trachea and the esophagus have undergone surgical correction. Of the vascular rings encountered, 15 had a double aortic arch and 8 had a right aortic arch with a constricting ligamentum arteriosum. Five had an aberrant right subclavian artery passing posterior to the esophagus producing dysphagia. The patients with the double aortic arch were all infants. Of the patients, 2 with a right arch and constricting ligamentum arteriosum and 1 with a retroesophageal subclavian artery were adults. Stridor from pressure on the trachea was the common symptoms in the infants. The diagnosis was confirmed by esophagograms; aortography was less helpful. The surgical approach was the same for all of the anomalies, through a posterolateral incision in the left 4th interspace. For the double arches, the smaller limb, usually the anterior, was divided. Division of the ligament relieved the constriction of the right aortic arches, and the anomalous right subclavian artery was divided near the aorta. There were no hospital deaths, but 1 infant with a double aortic arch operated upon at 2 wk old and with a tracheostomy died at home 7 mo. later.

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