TREATMENT OF PATIENTS WITH ESOPHAGEAL ATRESIA AND RIGHT AORTIC ARCH

Abstract

Right-sided (right, in dextral position) aortic arch (RAA) is recorded in approximately 5% of esophageal atresia (EA) patients. This vascular abnormality may complicate the surgical treatment of EA and is still an unsolved problem in pediatric surgery. Conventional methods for determining the anatomy of the aortic arch do not always provide accurate data, which can lead to thoracotomy on the side of the aortic arch. Skills and preferences of the surgeon still determine the choice of surgical approach in EA patients with RAA. For most experienced surgeons, to make anastomosis of the esophagus in patients with RAA from right access is not so difficult. However, in EA patients with RAA, combined with the vascular ring, left-sided thoracotomy can make the final combined reconstruction technically simpler. In this scientific review, we sought to determine the prevalence rate of RAA in the population of EA patients, the level of pre-operative evaluation of this vascular anomaly, and the existing surgical strategies that consist in choosing the optimal side for access to the esophagus.