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Ann Thorac Surg 1981;31:426-432
© 1981 The Society of Thoracic Surgeons

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Articles

Operation for Aortic Arch Anomalies

Division of Thoracic and Cardiovascular Surgery, Department of Surgery, the University of Iowa Hospitals and Clinics, Iowa City, IA

Accepted for publication September 10, 1980.

^* Address reprint requests to Dr. Ehrenhaft, Division of Thoracic and Cardiovascular Surgery, Department of Surgery, The University of Iowa Hospitals and Clinics, Iowa City, IA 52242

Forty-two patients with aortic arch anomalies resulting in tracheoesophageal compression were treated during the period 1948 through 1978. These anomalies are important causes of upper respiratory and esophageal obstruction in babies and small children and can be corrected safely with excellent relief of symptoms. Nineteen patients (45%) had a right aortic arch with a ligamentum arteriosum, 17 patients (40%) had double aortic arches, and 6 patients (15%) had aberrant right subclavian arteries. Other associated congenital malformations and mental retardation were seen in 15 patients (36%). Diagnosis was accurately made in 38 patients (90%) by barium esophagogram. Basic surgical principles include exposure through a left thoracotomy, complete identification of the aortic arch anatomy, and division of the constricting ring. Surgical treatment resulted in 2 deaths (5%), and 1 patient died late. Early postoperative respiratory complications were common. All survivors were relieved of their symptoms late (m, 94 months) postoperatively.

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