If you are looking for specific and public information about the aortic arch, or if your child has double aortic arch, we recommend that you read on to learn more about the double aortic arch. Doctors say that one of the congenital defects of the heart is the vascular ring, which is the most common type of aortic arch between the vascular rings.
The baby and infant may have this defect but have no specific symptoms ( asymptomatic), but a group of infants may have non-specific manifestations such as difficulty breastfeeding and swallowing and difficulty gaining weight.
In infants who have weight gain disorders and symptoms (such as shortness of breath or difficulty swallowing) They do not respond to routine treatment. An echocardiogram (ECG) should be performed to diagnose the presence of a double aortic arch, and a barium or barium swallow test should be performed to check for esophageal pressure structures.
Sometimes infants and toddlers develop recurrent lung tissue infections or pneumonia and develop respiratory symptoms.
It is said that there are no accurate and reliable statistics on the annual number of newly identified cases of dual arch Ivory.
It is said that among congenital cardiovascular disorders and malformations, one percent of them will belong to the vascular rings, and the double aortic arch is also classified as a vascular ring.
Forty-five to sixty-five percent of cases and neonates undergoing correction surgery for these malformations have double aortic arch. In general, this cardiovascular malformation is rare.
Doctors have identified DiGeorge Syndrome, which is associated with 22q11delletion, as a rare underlying cause of this cardiovascular malformation.
Double aortic arch
The following figure (Figure a) shows the difference between a normal aorta and a double aortic arch.
Symptoms of double aortic arch
Vascular ring pressure on the trachea and airways can cause respiratory symptoms and manifestations.
Vascular ring pressure on the esophagus is associated with difficulty swallowing.
Impaired weight gain is also observed in infants.
Dual aortic arch is sometimes associated with the following congenital cardiovascular malformations:
- Transposition of the great arteries
- Tetralogy of Fallot
- Ventricular septal defect
- Truncus arteriosus
Normally, the aorta, which is the body’s artery, twists or bends as it exits the left ventricle and moves upward, moving toward the abdomen.
In infants with dual aortic arching, the aortic artery coming out from the left ventricle becomes bifurcated instead of maintaining the integrity, and in much rarer cases it may become multiple.
If you look at photo “a”, you can see that in aortic dual arc malformation, vascular ring puts pressure on the esophagus and trachea, causing respiratory symptoms such as shortness of breath and difficulty swallowing the baby.
Boys and girls are equally affected by this malformation
Complications of dual aortic arch
One of the uncommon complications of rare clinical manifestations of double aortic arch is recurrent lung tissue infections or recurrent pneumonia.
Causes of recurrence in the dual aortic arch
Immune deficiency, cystic fibrosis, interstitial and esophageal fistulas, and pulmonary hyperemia are common causes of recurrent pneumonia in young children and infants.
Sometimes due to the compressive effects of vascular rings caused by congenital malformations of the aortic arch. The dual arch of the aorta is one of its types, the trachea and esophagus are under pressure.
Tracheal stenosis interferes with the clearance of lung secretions, and esophageal stenosis increases the likelihood of food aspiration into the trachea.
So one of the rare causes of recurrent pneumonia in infants can be double aortic arch.
Tracheal stenosis due to vascular ring pressure will be accompanied by shortness of breath, abnormal sound in the airways above the lungs called stridor sound, and wheezing.
A real case with a double aortic arch
In a real case, a two-year-old child with a fever and symptoms of a lung infection is taken to a pediatric emergency room.
A two-year-old child has a history of wheezing and difficulty swallowing and has been hospitalized four times for cough, fever, lung infection, or pneumonia.
Doctors immediately start appropriate antibiotic treatment for pneumonia in a two-year-old child, but at the end of the treatment they see that the fever has gone, but there is still wheezing and stridor.
In the child’s documents, there was an image of the esophagus and stomach taken with the barium swallow technique, which showed esophageal stenosis due to a compressive factor.
Doctors suspect cardiovascular malformations and vascular rings for a child undergoing CT angiography, in which they observe a double aortic arch.
Therefore, in children with permanent and persistent respiratory symptoms and manifestations, the physician should consider the double aortic arch, which will be the first diagnostic step in barium swallowing. However, it is emphasized not to use this method in cases where there is a suspicion of a communication path or fistula between the trachea and esophagus.
The last word
In general, you need to be aware of your child’s symptoms, especially respiratory symptoms, and if the symptoms persist, be sure to go to specialized medical centers for a thorough medical examination. Early diagnosis will make treatment easier and more effective.
Choosing a good and experienced specialist in the effectiveness of treatment and control of the child’s symptoms will be very important and necessary. Be careful about this.