Tracheal compression due to an elongated aortic arch in patients with congenital heart disease: evaluation using multidetector-row CT.
BACKGROUND
The airway can become obstructed as a result of compression by an elongated aortic arch.


OBJECTIVE
In this study we evaluated tracheal compression using multidetector-row CT in patients with congenital heart disease and an elongated aortic arch.


METHODS
The trachea was measured at the level of the aortic arch in 205 children and young adults and then the severity of tracheal compression was determined by measuring the tracheal diameter ratio (short axis diameter/long axis diameter). Patients were divided as follows: group I (normal aortic arch; n=166), group II (transversely running aortic arch; n=22), and group III (elongated aortic arch; n=17). From the viewpoint of the relationship of the great arteries, group II had D-malposition, and group III had L-malposition.


RESULTS
Age, height, weight and body surface area were significantly correlated with the short and long axis diameter in group I. There was a negative correlation between tracheal diameter ratio and the physical size parameters. The tracheal diameter ratio in group III was 0.50+/-0.13, which was significantly lower than in groups I and II (P<0.01 and 0.05, respectively).


CONCLUSIONS
Even apparently asymptomatic patients with an elongated aortic arch can have tracheal compression. An elongated aortic arch may be a useful predictor of tracheal compression.
Watanabe
Noriko
N
Department of Pediatrics, University of Tokushima, Tokushima 770-8503, Japan.
Hayabuchi
Yasunobu
Y
Inoue
Miki
M
Sakata
Miho
M
Nabo
Manal Mohamed Helmy
MM
Nakagawa
Ryuji
R
Saijo
Takahiko
T
Kagami
Shoji
S
D000293:Adolescent; D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D001015:Aortic Arch Syndromes / Q000150:complications* / Q000000981:diagnostic imaging*; D001027:Aortography / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014135:Tracheal Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D055815:Young Adult