Ryu Changwan, Puchalski Jonathan, Perkins Michael, Honiden Shyoko
Yale University School of Medicine, Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, United states.
Respir Med Case Rep. 2015 Dec 17;17:37-9. doi: 10.1016/j.rmcr.2015.12.002. eCollection 2016.
Vascular rings are congenital malformations of the aortic arch. A double aortic arch (DAA), the most common type of vascular ring, results from the failure of the fourth embryonic branchial arch to regress, leading to an ascending aorta that divides into a left and right arch that fuse together to completely encircle the trachea and esophagus. The subsequent DAA causes compressive effects on the trachea and esophagus that typically manifests in infancy or early childhood. Adult presentations, particularly in the elderly, are exceedingly rare. Historically such patients have a long-standing history of dyspnea on exertion and dysphagia, with many assumed to have obstructive lung or intrinsic cardiac disease. We describe a case of an elderly woman who presented with respiratory failure due to DAA. In her case, surgery was not feasible and we describe our experience with airway stenting.
血管环是主动脉弓的先天性畸形。双主动脉弓（DAA）是最常见的血管环类型，它是由于第四对胚胎鳃弓未能退化所致，导致升主动脉分为左、右弓，二者融合在一起完全环绕气管和食管。随后，双主动脉弓会对气管和食管产生压迫作用，通常在婴儿期或幼儿期出现症状。成人发病，尤其是老年人，极为罕见。过去，这类患者长期存在劳力性呼吸困难和吞咽困难的病史，许多人被认为患有阻塞性肺病或原发性心脏病。我们描述了一例因双主动脉弓导致呼吸衰竭的老年女性病例。在她的病例中，手术不可行，我们介绍了气道支架置入的经验。
