Pediatric Heart Expert Forum
Double arch with other issues
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Double arch with other issues

Hi - this is what my consulatant has wrote to my doctor, please can you explain.

The CT scan clearly shows a double aortic arch which looks symmetrical. If anything the right sided arch looks slightly larger than the left, although both arches do seam to give rise to their respective subclavian and carotid archeries. There does a ppear also to be a little stenosis just distal to the left subclavian artery. The surgeon approach would be to divide the left side via a lateral toractomy.

Please can someone explain this to me
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773637_tn?1327450515
This is just saying that there is a double aortic arch and that the head and neck arteries arise as expected.  There is some mild obstruction in the aorta beyond where the artery to the left arm comes off.  Finally, the planned surgical approach will be a thoracotomy, which is through an incision on the side and back under the shoulder blade.  I recommend that you discuss these questions with your primary cardiologist more completely so that your questions are answered appropriately.
8 Comments
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Avatar_m_tn
Thank you so much for all ypur posts, you have helped me greatly. Can I ask you what are the potential risks of the surgery that my son will face should anything not go right. I dont want to look on the bleak side but what are the chances of him dying under surgery of this sought and do you know how long the operation should take to perform?
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773637_tn?1327450515
The risks, while not zero, are not large, either.  That said, they depend upon the skill and experience of the surgeon as well as the other providers and team caring for him intra- and post-operatively.  There is a risk for bleeding and infection.  There is a risk that the aortic arch will have residual narrowing or damage.  There is also a risk that a nerve that controls the vocal chords, which is quite close to the area, can be damaged.  Finally, there is a small but present risk of death, though this typically occurs due to complications of other aspects of the perioperative procedure, such as infection, etc.  Overall, though, for specific information, you need to discuss this with your son's surgeon.
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Avatar_m_tn
Hi Again, Williams surgery has been planned for next week which is scary, due to his previous brain damage which he recovering really well from they want to do a nuerological assessment to see how William is, can i ask your oppinion, can there be an increased risk of further brain damage from this operation as my feeling is that hes done so well i am not prepared to take the risk of operating for him to go back to square one again. can I have your oppinion please and what they will be looking out for during the assessment
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773637_tn?1327450515
I cannot say that there is no risk, and a lot depends on the anesthesia and surgical team.  I do not know their experience with this, so I cannot assess risk.  In good hands, the risk of brain complications from this should be minimal, if any.
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Avatar_m_tn
Thank you once again for your reply, the surgery is being done in Leeds England, a surgeon called Raphael Guerro who has been in the uk for a while but came from Melborne I believe. I am just concerned that when they disect the ring there may be a stop in blood flow or something which may cause iscemic damage or stroke. He should ne be more at risk should he due to his previous brain injury? do you know why they would be doing a full nuero assessment?
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Avatar_m_tn
Hi Jeffey, you will be pleased to hear that my sons surgery went very well. The operation went all to plan last 3 hours in total, he was intubated at 9 in the morning and extubated at about 5pm, he was in ICU for 24 Hours and home in 5 days. he has got mild tracheomalacia but never required any medication or anything and the stridor seams to have gone except on excersize when its still present which I am told will take some time. Its been 2 weeks since the opoeration and one thing im concerned about is that although his sickness has stopped instantly he can only tollorate liquids at the minute and is gagging on solids.... he had a bad cough when he came out of ICU which has gone now, no temp or anything though. the doctors think he could have picked up a virus and with intubation etc his throat could be soar still, do you have any other explanation, surely nothing from the operation could have made it worse?
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A related discussion, Double Arched Aorta was started.
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773637_tn?1327450515
Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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