Chen Y C, Hsieh K S, Chen C W, Chi C S
Section of pediatrics, Veterans General Hospital-Taichung, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1992 Dec;50(6):513-9.
This report is on three double aortic arch cases. They were diagnosed in our department between 1982 and 1992. The first case was complicated by dilated cardiomyopathy whose diagnosis was delayed due to a lack of clinical experience. Corrective surgery relieved the airway obstruction and his breathing improved postoperatively. The patient finally died of heart failure due to concurrent progressive dilated cardiomyopathy one and half years later. The second and third cases were diagnosed on the day of admission by a barium esophagogram and echocardiogram. MRI (Magnetic resonance image) of the cardiovascular system on these two patients revealed no other associated abnormalities. No angiography was done on the third case. They underwent surgery with excellent results. In any infant younger than 3 months with dyspnea and dysphagia, double aortic arch should be suspected. The esophagogram can show extrinsic compression. An echocardiogram can reveal two aortic arches. Both procedures can be performed easily and safely at the bedside. We recommend that these to be considered as routine examinations in such patients.
本报告涉及三例双主动脉弓病例。这些病例于1982年至1992年间在我科确诊。第一例合并扩张型心肌病，由于缺乏临床经验，诊断有所延迟。矫正手术解除了气道梗阻，术后患者呼吸改善。该患者最终在一年半后因并发进行性扩张型心肌病死于心力衰竭。第二例和第三例在入院当天通过食管钡餐造影和超声心动图确诊。这两名患者的心血管系统磁共振成像（MRI）未显示其他相关异常。第三例未进行血管造影。他们接受了手术，效果良好。对于任何年龄小于3个月、有呼吸困难和吞咽困难的婴儿，都应怀疑双主动脉弓。食管钡餐造影可显示外部压迫。超声心动图可显示两个主动脉弓。这两项检查均可在床边轻松、安全地进行。我们建议将这些检查作为此类患者的常规检查。
