Sugical repair of double aortic arch associated with complex cardiac anomalies

Abstract

Objective To evaluate the clinical characteristics, diagnosis and surgical repair methods of double aortic arch(DAA)associated with complex cardiac anomalies. Methods Retrospectively analyzed the clinical data of the 5 DAA associated with complex cardiac anomalies patients, 4 males and 1 female, age from 41 days to 19 years old, weight 4.3-56.0 kg. Accompanied cardiac malformites including 2 cases with TOF, 2 cases with DORV, and 1 case with d-TGA. 4 cases were diagnosed DAA via MSCT and were surgical treated combined with cardiac malformations at same stage. 1 case of DAA associated with d-TGA experienced stubborn pulmonary infection with increased airway resistance and could not tolerate ventilator weaning after aterial switch operation. Then he was diagnosed DAA with left arch atresia through MSCT. So, the patient underwent another surgery to excise the left aortic arch. Results One case worsened postoperatively by the cause of vomiting and aspiration and then died. The other four were survival and discharged with no DAA repair relating complication. Conclusion Double aortic arch can be cured by surgical repair and DAA with cardiac defects can be operated in one stage via median sternotomy. Congenital vascular ring should be considered in patients with stubborn and unexplained respiratory symptoms, who should receive timely imaging examinations for accurate diagnosis and surgical treatment at the early stage. Key words: Vascular malformation; Surgical repair; Tetralogy of Fallot; Double aortic arch; Double outlet of right ventricle