Hi I have a 2 yr old that has a know diagnosis of hypotonia,abberent right subclavian artery and a 5 mm ASD. She also has airway issues (Tracheomalacia) and went blue as a baby. I have noticed she turns dusky and blue around the mouth and eye sockets while on her back. Whether it is a diaper change or after a bath. Early on the cardiologist brushed it off, but it is concerning me. She has not had any surgeries to repair. But the abberent artery seems to be continuously causing feeding (only can eat purees and a very small amount of soft solids) and breathing problems. (sleep apnea, recuurent URI, aspiration) Is this blueness a new sign that she needs surgery? She was evaluated a yr ago and it was suggested to wait and see.
Blueness around the mouth and eyes is due to prominence of the collection of veins that are found around the mouth and eyes. Even though there mught be a bluish appearance, as long as the lips and tongue are a normal pink color, and someone has checked her oxygen saturation level along the line and it was normal, then there should not be a problem there. Generally an ASD of 5 mm would not cause any clinical symptoms or blueness. Aberrant course of the right subclavian artery with a left aortic arch is also considered a variant of normal, and should not be associated with any clinical symptoms. If it were the opposite side (a right aortic arch with aberrant left subcalvian artery) then that is a different story; that can be associated with clinical symptoms. So based on what you have described there is no clear cut indication for an operation.
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