Journal of Vascular and Endovascular Therapy

Double aortic arch with TOF: Single stage approach via median sternotomy

3^rd Edition of World Congress & Exhibition on Vascular Surgery
May 24-25, 2018 London, UK

Soumya Guha

PGIMER & Dr. RML Hospital, India

ScientificTracks Abstracts: J Vasc Endovasc Therapy

DOI: 10.21767/2573-4482-C1-002

Abstract

Double 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 Cardio-thoracic and vascular Surgery from the reputed PGIMER & RML Hospital, New Delhi. He is already a specialist in the field of General Surgery from one the premier government hospitals in his country, the Safderjung Hospital in New Delhi which sees a daily footfall of roughly 8000-10000 patients. He has published papers in internationally acclaimed journals and has presented his papers as well in international conferences.

Email:surya_blue@yahoo.co.uk