Dpuble aortic arch - clinic, diagnosis and therapy in children and adults

Double aortic arch is a rare vascular anomaly which usually causes tracheal and esophageal compression in the first few months of life. During the las t 30 years, 7 children, 2 to 24 months old, and one 29-year-old woman with double aortic arches have been treatedatour institution. Symptoms, diagnosi s and treatment of these patients were evaluated. Dyspnoe, strider, recurre nt pulmonary infections, feeding problems and failure to thrive were the le ading symptoms. Despite typical symptoms from early childhood, the diagnosi s was missed in our adult patient. Typical compression of the esophageus an d the trachea was visualized by esophagography by 7 and bronchoscopy/-graph y by 6 patients. Angiography was performed in all children, whereas magneti c resonance angiography and computed tomography were done in the adult pati ent. Resection of the smaller aortic arch, left in 3 and right in 5, throug h a right or a left posterolateral thoracotomy was uncomplicated and fully resolved the symptoms in all patients. Typical symptoms in early childhood should lead to prompt diagnosis and sur gical treatment of double aortic arch. Surgical resection of the smaller ao rtic arch should also be performed in oligosymptomatic patients to prevent complications later. Preoperative angiography can be replaced by the less i nvasive magnetic resonance imaging and computed tomography.