Obstruction of the airway by the aorta: an observation in infants with congenital heart disease

Ma, Chuang; Wolfson, BJ; En, Faerber; Williams, JL; Rk, Balsara

doi:10.2214/ajr.140.4.675

Cited by 13 publications

(6 citation statements)

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“…Airway obstruction related to a dilated aorta has been described in several case reports and case series, [4][5][6][7][8][9] with the underlying heart diseases including truncus arteriosus, tetralogy of Fallot, isolated ventricular septal defect, and cervical arch. Similarly, in our study, airway obstruction by the aorta was the most common aetiology.…”

Section: Discussionmentioning

confidence: 99%

Airway obstruction in children with complex conotruncal cardiac anomalies

2021

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The incidence of airway obstruction in patients with complex CHD other than vascular rings and absent pulmonary valve syndrome is unknown. We reviewed pre-operative CT and clinical data of children with conotruncal abnormalities to assess for airway obstruction. Airway obstruction was common (41% of patients), often moderate to severe, of diverse aetiology, and most commonly associated with a right aortic arch. Patients with airway obstruction showed a trend towards a higher mortality rate. Patients with complex conotruncal abnormalities should be assessed for airway obstruction as it may help predict the need for additional interventions and assist with prognostication.

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Section: Discussionmentioning

confidence: 99%

Airway obstruction in children with complex conotruncal cardiac anomalies

2021

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“…we attributed her respiratory compromise to the vascular ring and hypertensive pulmonary arteries, since when the patient was initially evaluated, we were unaware of any report of bronchial compression in TA caused by a posteriorly displaced dilated ASAO that compressed the RPA and LMB against the DSAO. Bronchial compression/stenosis in patients with TA has rarely been reported [5,6,7,8,9,10]. Furthermore, those cases were autopsy reports without data from precise imaging modalities, such as bronchoscopy and chest CTA with clinical correlations, and only two of them discussed the possible cause [9, 10].…”

Section: Discussionmentioning

confidence: 99%

“…Bronchial compression/stenosis in patients with TA has rarely been reported [5,6,7,8,9,10]. Furthermore, those cases were autopsy reports without data from precise imaging modalities, such as bronchoscopy and chest CTA with clinical correlations, and only two of them discussed the possible cause [9, 10]. Postmortem examination of the patient of Habbema et al [9] revealed the left upper lobe bronchus was squeezed between the left aortic arch posteriorly and left pulmonary artery anteriorly, which were tightly joined by an obliterated ductus arteriosus.…”

Section: Discussionmentioning

confidence: 99%

“…However, the abnormal topography of the left pulmonary artery passing ‘anterior’ to the left upper lobe bronchus is particularly unusual for the visceroatrial situs solitus patient [9]. Capitanio et al[ 10] described a patient with a right aortic arch whose distal trachea and LMB were compressed by a posteriorly displaced dilated ASAO. Compression of the main bronchus in this situation, however, usually occurs on the side of the aortic arch [3, 11].…”

Section: Discussionmentioning

confidence: 99%

“…Compression of the main bronchus in this situation, however, usually occurs on the side of the aortic arch [3, 11]. Moreover, frontal and lateral chest radiographs were the only imaging modalities used, and a precise correlation between imaging results and clinical findings was lacking [10]. …”

Section: Discussionmentioning

confidence: 99%

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The Rare Association of Truncus Arteriosus with a Cervical Double Aortic Arch Presenting with Left Main Bronchial Compression

Huang

Su²,

Chu³

et al. 2008

Cardiology

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Truncus arteriosus, a double aortic arch, and a cervical aortic arch are all rare cardiovascular anomalies. We experienced a unique female newborn with the rare combination of truncus arteriosus with a cervical double aortic arch, which probably resulted from abnormal persistence of the bilateral 2nd or 3rd rather than the 4thembryonic aortic arches and failure of regression of the right 8th somitic segment of the right dorsal aorta. She presented with respiratory distress soon after birth, which was initially attributed to the vascular ring and hypertensive pulmonary arteries. Our inability to relieve her respiratory compromise by surgical division of the vascular ring and main pulmonary artery banding prompted the diagnosis of left main bronchial compression caused by a posteriorly displaced dilated ascending aorta that compressed the right pulmonary artery and left main bronchus against the descending aorta. The patient then underwent successful left main bronchus stent implantation. We speculate the cervical double aortic arch is redundant in nature and is a loose ring that may not cause tracheal compression. Nevertheless, a posteriorly displaced dilated ascending aorta in patients with truncus arteriosus may compress the right pulmonary artery and the main bronchus on the side of the aortic arch against the descending aorta.

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Airway Obstruction

Boothroyd

2003

Pediatric ENT Radiology

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Obstruction of the airway by the aorta: an observation in infants with congenital heart disease

Cited by 13 publications

References 0 publications

Airway obstruction in children with complex conotruncal cardiac anomalies

Airway obstruction in children with complex conotruncal cardiac anomalies

The Rare Association of Truncus Arteriosus with a Cervical Double Aortic Arch Presenting with Left Main Bronchial Compression

Airway Obstruction

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