title: Management of an elderly patient with respiratory failure due to double aortic arch.
abstract: Vascular rings are congenital malformations of the aortic arch. A double aortic arch (DAA), the most common type of vascular ring, results from the failure of the fourth embryonic branchial arch to regress, leading to an ascending aorta that divides into a left and right arch that fuse together to completely encircle the trachea and esophagus. The subsequent DAA causes compressive effects on the trachea and esophagus that typically manifests in infancy or early childhood. Adult presentations, particularly in the elderly, are exceedingly rare. Historically such patients have a long-standing history of dyspnea on exertion and dysphagia, with many assumed to have obstructive lung or intrinsic cardiac disease. We describe a case of an elderly woman who presented with respiratory failure due to DAA. In her case, surgery was not feasible and we describe our experience with airway stenting.
authors.affiliation: Yale University School of Medicine, Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, United states.
authors.forename: Changwan
authors.initials: C
authors.lastname: Ryu
authors.affiliation: Yale University School of Medicine, Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, United states.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Puchalski
authors.affiliation: Yale University School of Medicine, Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, United states.
authors.forename: Michael
authors.initials: M
authors.lastname: Perkins
authors.affiliation: Yale University School of Medicine, Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, United states.
authors.forename: Shyoko
authors.initials: S
authors.lastname: Honiden
keywords: Airway stent; Double aortic arch; Vascular ring