Double aortic arch with dominant left arch and right ligamentum arteriosum.
This case report describes a rare example of double aortic arch with a dominant left aortic arch, patent minor right aortic arch, left descending aorta, and right ligamentum arteriosum causing tracheobronchial compression in a twin baby girl with DiGeorge syndrome. She also had large right subclavian artery arising from right-sided diverticulum of Kommerell, aplastic thymus, T cell lymphopenia with normal immunoglobulin, hypocalcemia, and hypomagnesemia. The diverticulum of Kommerell was resected and minor right aortic arch, right ligamentum arteriosum, and right subclavian artery were divided through right posterolateral thoracotomy. Aortopexy was performed under bronchoscopic guidance to relieve the airway compression. We strongly suggest a right-sided approach in this type of vascular arrangement for easy access and better outcome.
Hashmi
Syed Faisal
SF
Departments of Pediatric Cardiothoracic Surgery, Royal Hospital for Sick Children, Glasgow, UK. faisal_hashmi38@hotmail.com
Hanif
Mohammad
M
Maroo
Sanjay
S
Pollock
J C S
JC
D000402:Airway Obstruction / Q000473:pathology; D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000601:surgery; D001015:Aortic Arch Syndromes / Q000473:pathology* / Q000601:surgery; D004062:DiGeorge Syndrome / Q000473:pathology* / Q000601:surgery; D004240:Diverticulum / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008022:Ligaments / Q000002:abnormalities* / Q000601:surgery; D013348:Subclavian Artery / Q000002:abnormalities / Q000601:surgery