Double Aortic Arch Repair : An Interesting Case Scenerio

The term “VASCULAR RINGS” refers to any vascular anomaly causing tracheoesophageal compression. Double aortic arch is the most common of the complete vascular rings, causing tracheo-esophageal compression. We present this rare case report of a double aortic arch with dominant right aortic arch, presenting with extrinsic trachea-bronchial obstruction A 11-month-old female child was referred to our institution with stridor since 1 month of age and recurrent respiratory infection. Chest x-ray showed no obvious indentation of the tracheal shadow. Echocardiographic evaluation showed double aortic arch with dominant right arch and right descending aorta, causing vascular ring and tracheal obstruction. Patient was further evaluated with cardiac catheterization and angiography which revealed double aortic arch. The patient underwent division of the left aortic arch through a left postero-lateral thoracotomy approach. The left aortic arch was divided at its junction with the descending aorta and the cut edges were oversewn. In summary, vascular rings, more commonly the double aortic arch, are an important cause of tracheo-esophageal compression, the clinical suspicion and diagnosis of which can lead to early surgical intervention and relief.