double aortic arch
Introduction
Introduction to double aortic arch The double aortic arch is the most common form of vascular ring in the clinic. The aortic arch is divided into two left and right aortic arches, and then the trachea and esophagus are wrapped. Usually, the right arterial arch is thicker than the left artery, and then extends to the esophagus and merges into the lower extremity. The aorta, located on the left side of the midline of the trunk, occasionally has a left arterial arch that is locked. A complete vascular ring is formed by the aortic arch on both sides of the blood vessels and esophagus. Accompanied by the anterior ascending aortic arch and posterior esophageal arch or posterior descending aorta. Usually the arterial catheter is on the left side and is not a necessary component of the vascular ring, but its length can affect the severity of clinical symptoms. Only 22% of patients have congenital heart malformations. Surgical treatment should be performed in cases where the aortic arch and its branch malformation produce respiratory and esophageal compression symptoms. According to the specific conditions of the lesion, the blood vessel or the esophageal tube that is compressed or freed by the trachea or esophagus or the fibrous cord-like tissue including the arterial ligament is fully released, and the free trachea and food are fully released to eliminate the symptoms. basic knowledge The proportion of illness: 0.0005%--0.0008% Susceptible people: no special people Mode of infection: non-infectious Complications: arrhythmia
Cause
Cause of double aortic arch
The disease belongs to congenital dysplasia, and its etiology is not clear. It is currently considered to be related to embryonic dysplasia. For example, the mother uses drugs that are forbidden by pregnant women during pregnancy, and at the same time, insufficient intake of folic acid or vitamins such as fruits and vegetables during pregnancy. At the same time, genetic factors, environmental factors and low mood during pregnancy, often crying may cause abnormal development of the child's double aortic arch.
Prevention
Double aortic arch prevention
Maternal women should be prenatally checked to avoid the birth of such children.
Complication
Double aortic arch complication Complications arrhythmia
The disease is serious and requires timely surgical treatment. There are also many complications, including cardiac insufficiency, arrhythmia, and pulmonary hypertension.
Symptom
Double aortic arch symptoms common symptoms aortic arch right dysphagia aortic arch distortion cough repeated upper respiratory tract infection aortic dislocation respiratory distress syndrome
This malformation has no obvious influence on blood flow, but the formation of the arterial ring is narrow, and the arterial ligament can pull the pulmonary artery tightly, which can compress the trachea and esophagus and cause respiratory distress, respiratory infection and difficulty swallowing. Mainly for Fallot's quadruple disease and complete transposition of the great arteries.
Symptoms of children with double aortic arch can be severe, clinical manifestations of inspiratory wheezing, difficulty swallowing, long-term cough, head tilting, squatting angulation, often pneumonia, occasional breath holding and purpura attacks.
Chest radiograph showed unilateral or bilateral lung field hyperinflation, due to obstruction of the main part of the trachea or bronchus, esophageal tincture examination, sawtooth notch on both sides of the esophagus (or right side) in the anterior and posterior position And the right side of the impression is deeper, a large zigzag notch in the posterior position and the left anterior oblique chest radiograph is characteristic of the posterior esophageal aortic arch.
Examine
Double aortic arch examination
Chest X-ray
In cases without other congenital heart malformations, the chest radiograph may have no abnormalities. Cases of the double aortic arch can show a bilateral aortic arch bulge, and the right side is more pronounced. Esophageal angiography can show the inferior esophagus on the upper third and fourth levels of the thoracic vertebrae. The right aortic arch has a larger impression and a higher position. The left aortic arch has smaller impression and lower position. The tomography may show signs of compression of the tracheal lumen. In the right aortic arch, the chest X-ray showed only the aortic arch bulge on the right side, but the left side was absent. Esophageal angiography was performed at the aortic arch site, and the esophagus was pushed to the left and the impression was displayed. In cases of ectopic subclavian artery, esophagography can show that the posterior wall of the esophagus is subjected to oblique or spiral compression by vascular compression. In infants, esophageal angiography should be performed with iodized oil or water-soluble contrast agents. Because contrast agents such as inhalation of tracheobronchial tubes may increase the risk of breathing difficulties or cause aspiration pneumonia.
Bronchoscopy
Bronchoscopy can identify the site of compression of the trachea, and can observe pulsation of the blood vessels under pressure. However, respiratory mucosal trauma and edema can aggravate respiratory obstruction and must be very careful.
Aortic angiography
Aortic angiography is the most reliable diagnostic method for the diagnosis of aortic arch and its branch deformities. A catheter is inserted into the ascending aorta, and a contrast agent is injected to perform aorta and its branch angiography. Two-way film examination can show the origin, direction, thickness and other abnormalities of the aortic arch and its branches, thereby confirming the diagnosis.
Diagnosis
Diagnosis and diagnosis of double aortic arch
Aortic angiography is the most reliable diagnostic method for the diagnosis of aortic arch and its branch deformities. A catheter is inserted into the ascending aorta, and a contrast agent is injected to perform aorta and its branch angiography. Two-way film examination can show the origin, direction, thickness and other abnormalities of the aortic arch and its branches, thereby confirming the diagnosis.
