Prenatal Diagnosis of Double Aortic Arch: Associated Findings and Postnatal Clinical Outcomes

Abstract

Objectives The aim of this study is to share our experience in the prenatal diagnosis and characteristics of double aortic arc and neonatal consequences. Methods We retrospectively analyzed 2153 fetal echocardiography reports between 2014 and 2019 years. Records of 14 fetuses with double aortic arc were examined. Prenatal and postnatal medical records, sonographic images, genetic reports, associated cardiac and extracardiac anomalies, and neonatal clinical results of affected fetuses were reviewed retrospectively. Results DAA was isolated in 9 of 14 (64.2%) cases, while the other five cases had cardiac or extracardiac accompanying ultrasound findings. Three of cases (21.4%) were associated with other heart pathologies, including ventricular septal defect, double outlet right ventricle, and persistent left superior vena cava. In 10 cases (71.43%), the right aortic arch diameter was dominant. The left aortic arc was dominant in two cases and both arcs were symmetrical in the remaining two cases. 22q11 microdeletion was the only chromosomal abnormality and was detected in two of nine patients who accepted genetic analysis. Intrauterine fetal death occurred in two of the cases. After birth, in 58.3% (7/12) of the live born cases various degrees of symptoms. Surgical repair was performed with the division of the aorta to all symptomatic cases at different times according to severity of the complaints. Conclusions Since it can cause severe respiratory distress in the postnatal period and may accompany chromosomal anomalies, it is important to provide antenatal diagnosis of double aortic arc and adequate counseling to the family.

Short‐term outcome after the prenatal diagnosis of right aortic arch

“…However, our results are in line with the meta‐analysis of D’Antonio et al., reporting a pooled surgical intervention rate of 18% 14 . Our mean age at surgery of 17 months is also compared with other studies 4,17,26 . Additionally, the surgical rate was higher in children with a DAA compared to an RAA + LAD, as one may expect as the vascular ring of a DAA is generally tighter.…”

“…14 Our mean age at surgery of 17 months is also compared with other studies. 4,17,26 Additionally, the surgical rate was higher in children with a DAA compared to an RAA + LAD, as one may expect as the vascular ring of a DAA is generally tighter. These findings are consistent with recent studies, in which the majority or all of the children with a DAA required surgery.…”

“…These findings are consistent with recent studies, in which the majority or all of the children with a DAA required surgery. 4,26,27 A detailed prenatal diagnosis of the type of RAA is essential as this influences the prenatal counseling and the location of delivery.…”

Aortic Arch Anomaly, Respiratory Distress and Difficult Feeding in a Premature Infant: A Case Report

“…In neonates, aortic anomalies could lead to clinical symptoms, including respiratory distress, cyanosis, and dysphagia due to the compression of the trachea and esophagus (Reynolds et al, 2015;Backer, 2020). With the availability of ultrasound technology, these conditions could be diagnosed prenatally (Bornaun et al, 2021;Babaoğlu et al, 2022). We present a case of a preterm infant diagnosed with an aortic arch anomaly that was causing persistent respiratory distress and feeding intolerance.…”