Buckwalter J, Sasaki C, Kopf G, Hellenbrand W, Kleinman C, Markowitz R
Ann Otol Rhinol Laryngol. 1983 Jul-Aug;92(4 Pt 1):383-6. doi: 10.1177/000348948309200418.
Cardiac and aortic arch anomalies are a well-known cause of tracheal and esophageal compression producing stridor and dysphagia. We present a rarely encountered aortic arch anomaly in a 12-month-old infant who suffered from intermittent pulmonary wheezing. A discussion of the subsequent evaluation including an esophageal contrast study, computed tomography, angiocardiography, and bronchoscopy, will emphasize the diagnostic importance of these examinations. Preoperatively, a variant of Celoria type B aortic arch interruption was established by cardiac catheterization. The ascending aorta solely supplied both carotid arteries. Both subclavian arteries arose from the descending aorta, and all flow to the descending aorta was supplied via bilateral markedly enlarged vertebral arteries as a bilateral subclavian steal. Three areas of tracheal compression were noted at bronchoscopy. The patient's anomalous circulation was improved by the placement of a Gore-Tex graft connecting the ascending and descending aorta. A right-sided arterial ligament was divided in order to further relieve tracheal compression.
心脏和主动脉弓畸形是导致气管和食管受压进而产生喘鸣和吞咽困难的常见原因。我们报告了一名12个月大的婴儿，患有间歇性肺喘鸣，其主动脉弓畸形较为罕见。本文将讨论后续评估，包括食管造影、计算机断层扫描、心血管造影和支气管镜检查，强调这些检查在诊断中的重要性。术前通过心导管检查确诊为Celoria B型主动脉弓中断变异型。升主动脉单独供应双侧颈动脉。双侧锁骨下动脉均发自降主动脉，所有流向降主动脉的血流均通过双侧明显增粗的椎动脉供应，即双侧锁骨下动脉窃血。支气管镜检查发现气管有三个受压部位。通过植入连接升主动脉和降主动脉的戈尔特斯移植物改善了患者的异常循环。为进一步缓解气管受压，切断了右侧动脉韧带。
