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May 24-25, 2018
London, UK
Vascular Surgery 2018
3
rd
Edition of World Congress & Exhibition on
Vascular Surgery
Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482
D
ouble aortic arch (DAA) is a rare accompaniment of Tetralogy
of Fallot (TOF). This case report describes successful
management of TOF with DAA via median sternotomy in a
3-year-old child. The approach selection for a surgery in these
patients is often quite puzzling to the surgeons especially those
encountering it for the first time. The non-dominant arch is divided
at the atretic segment. In the absence of an atretic segment the
non-dominant arch is divided between the ipsilateral subclavian
artery and the descending aorta. The distal non-dominant arch
beyond the ipsilateral subclavian artery is often difficult to access
from the midline and accounts for the controversy regarding
the approach (thoracotomy vs median sternotomy) and for the
prevalence of the two-incision approach wherein the arch is
tackled by a separate posterolateral thoracotomy. We modified
the placement of clamps to simplify the division of non-dominant
arch. We believe that division of the non-dominant arch can be
safely undertaken from the midline when coexisting cardiac
anomalies mandate an intracardiac repair under cardiopulmonary
bypass which also facilitates division of the non-dominant arch
Recent Publications
1. Harper AR, Dai M, Prabhatha RM. Tetralogy of fallot with
double aortic arch. Cardiol Young. 2011;21:695–696.
2. Emani SM. Sabiston &Spencer:Surgery of the Chest. 8th
edition. Elsevier;2010.
3. Kouchoukos NT, Blackstone EH, Kirklin JK, Hanley
FL. Kirklin/Barratt-Boyes:Cardiac Surgery. 4th ed.
Elsevier;2012.
4. Pankaj B, Munesh T, Bhan A. Dysphagia in an Adult
Tetralogy of Fallot with Double aortic arch. Images
Paediatr Cardiol. 2013;15(3):6-13
5. Dan, Z., Qiangfu, H., Liang, T., Changyu, L., Linnan, D. and
Laichun, S. Repair of double aortic arch in patients with
concomitant cardiac anomalies. J Card Surg. 2016; 31:
635–638.
6. Sachin Talwar, Anubhav Gupta, Shiv Kumar Choudhary,
Balram Airan. Absent left pulmonary artery and double
aortic arch in tetralogy of Fallot: reconstruction using
homograft saphenous vein or iliac artery. Interact
CardioVasc Thorac Surg. 2009; 8 (2): 277-279.
Biography
Dr. Soumya Guha is currently completing his residency programme in Car-
dio-thoracic and vascular Surgery from the reputed PGIMER & RML Hospi-
tal, New Delhi. He is already a specialist in the field of General Surgery from
one the premier government hospitals in his country, the Safderjung Hospi-
tal in New Delhi which sees a daily footfall of roughly 8000-10000 patients.
He has published papers in internationally acclaimed journals and has pre-
sented his papers as well in international conferences.
surya_blue@yahoo.co.ukDouble aortic arch with TOF: Single stage approach via
median sternotomy.
Soumya Guha
PGIMER & Dr. RML Hospital, India
Soumya Guha, J Vasc Endovasc Therapy 2018, Volume 3
DOI: 10.21767/2573-4482-C1-002