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Asian Cardiovasc Thorac Ann 2006;14:88
© 2006 Asia Publishing EXchange Ltd

IMAGES IN CARDIOTHORACIC MEDICINE AND SURGERY

Double Aortic Arch causing Tracheo-esophageal Obstruction

Ahmed A Arifi, FRCS, Randolph HL Wong, MRCS, Alan DL Sihoe, MRCS, Anthony V Manlulu, DPBS

Division of Cardiothoracic Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China

For reprint information contact: Ahmed A Arifi, MD Tel: 852 2632 2629 Fax: 852 2647 8273 Email: arifi64{at}surgery.cuhk.edu.hk, Division of Cardiothoracic Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China

A 3-month-old girl presented with respiratory distress and stridor requiring intubation and assisted ventilation. Bronchoscopy demonstrated extrinsic compression on the distal trachea. A Computed Tomography (CT) of thorax confirmed a double aortic arch (Figure 1Go). Echocardiography showed no associated abnormalities.


Figure 1
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  		Figure 1. (Left) A pre-operative CT thorax with 3D reconstruction of the heart and aorta shows left (LAA) and right (RAA) aortic arches of similar diameter, forming a complete vascular ring around trachea and left main bronchus. A patent ductus arteriosus (PDA) is not visualized, but a ‘knuckle’ on the distal left arch corresponding to its position was noted. (Right) The post-operative CT thorax shows very good separation between the divided left and right arches, relieving the airways compression.

 





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Anthony V Manlulu
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