Double aortic arch (DAA): An unusual cause of dysphagia

Abstract

Introduction: Vascular rings, due to the double aortic arch, are a class of congenital anomalies, considered as an important cause of tracheoesophageal compression. These anomalies are usually symptomless and thus are diagnosed fortunately when imaging is being performed for other reasons. Case Report:We report a clinical case of a patient with a history of dysphagia in his childhood, never labeled or treated. Conclusion:Currently, advanced imaging, especially computed tomography (CT), is the diagnostic procedure of choice of the double aortic arch. It can be associated with other anatomical variants. Surgical repair leads to excellent long-term prognosis.

Balanced Double Aortic Arch Causing Acute Tracheal Compression

“…It was first described by Wolman in 1939, 2 and represents 46% to 76% of complete vascular rings, and 0.8% to 2% of all congenital cardiovascular malformations. 1 , 3 …”

“…In case of failure of involution of the right arch, and persistence of the left arch a double aortic arch is formed creating a vascular ring around the trachea and esophagus, and joining together to the descending aorta. 1 , 2 , 4 …”

“…The double aortic arch (DAA) is an uncommon congenital anomaly caused by the persistence of a right aortic arch forming with the left aortic arch a complete vascular ring around the trachea and esophagus causing its compression. 1 It was first described by Wolman in 1939, 2 and represents 46% to 76% of complete vascular rings, and 0.8% to 2% of all congenital cardiovascular malformations. 1,3 In organogenesis, 6 pairs of aortic arches develop at different stages: the first 2 arches regress forming the maxillary, hyoid, and stapedial arteries.…”

“…In case of failure of involution of the right arch, and persistence of the left arch a double aortic arch is formed creating a vascular ring around the trachea and esophagus, and joining together to the descending aorta. 1,2,4 Usually in vascular rings, 1 arch is patent while the other is either focally of diffusely narrowed or atretic, and depending of the patency of the arches, 3 types are described: 3,4 • • Right sided dominant DAA: (55%-70%) the right arch is large and posterior and the left one is thinner and anterior. • • Left sided dominant DAA: (20%-35%) the left arch is large whereas the right arch is small or atretic.…”