Double Aortic Arch
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Definition
Double aortic arch is an abnormal formation of the aorta, the large artery that carries blood from the heart to the rest of the body. It is a congenital problem, which means that it is present at birth.
See also: Vascular ring
Alternative Names
Aortic arch anomaly; Double arch
Causes, incidence, and risk factors
Double aortic arch is a common form of a group of defects that affect the development of the baby’s aorta in the womb. These defects cause an abnormal formation called a vascular ring -- a circle of blood vessels.
Normally, the aorta develops from one of several curved pieces of tissue (arches). As babies develop in the womb, the arches split into several parts. The body breaks down some of the arches, while others form into arteries. A normally developed aorta is a single arch that leaves the heart and moves leftward.
In double aortic arch, some of the arches that should have changed into arteries or disappeared are still present at birth. Babies with a double aortic arch have an aorta that is made up of two vessels instead of one. The two parts to the aorta have smaller arteries branching off of them. As a result, the two branches go around and press down on the windpipe and the tube that carries food from the mouth to the stomach (esophagus).
A double aortic arch may occur in other congenital heart defects, including:
Double aortic arch is very rare. Vascular rings make up a small percentage of all congenital heart problems. Of these, a little more than half are caused by double aortic arch. The condition occurs equally in males and females.
References
Park MK. Park: Pediatric Cardiology for Practitioners. 5th ed. Philadelphia, Pa: Mosby; 2008.
Bernstein D. Other congenital heart and vascular malformations. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Behrman: Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders; 2011:chap 426.
Townsend Jr. CM, Beauchamp RD, Evers BM, Mattox KL. Townsend: Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders; 2008.
Review Date: 2/7/2012
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine; and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Aortic arch anomaly; Double arch
Symptoms
Because symptoms of double aortic arch are often mild, the problem may not be discovered until the child is a few years old.
The double aortic arch may press on the windpipe (trachea) and esophagus, leading to trouble breathing and swallowing. The severity of the symptoms depends on how much the aortic arch is pressing on these structures.
Breathing symptoms include:
Digestive symptoms may include:
Signs and tests
The symptoms may lead a doctor to suspect double aortic arch. Other tests will then be needed to diagnose this condition.
The following tests can help diagnose double aortic arch:
- Chest x-ray
- Scans that create cross-sectional images of the body (CT or MRI scan)
- Ultrasound examination of the heart (echocardiography)
- X-ray using a substance that outlines the esophagus (barium swallow)
References
Park MK. Park: Pediatric Cardiology for Practitioners. 5th ed. Philadelphia, Pa: Mosby; 2008.
Bernstein D. Other congenital heart and vascular malformations. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Behrman: Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders; 2011:chap 426.
Townsend Jr. CM, Beauchamp RD, Evers BM, Mattox KL. Townsend: Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders; 2008.
Review Date: 2/7/2012
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine; and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Aortic arch anomaly; Double arch
Treatment
Surgery can be done to fix double aortic arch. The surgery separates off the smaller branch of the double aortic arch to relieve pressure on the esophagus and windpipe (trachea).
The surgeon ties off the smaller branch and separates it from the larger branch. Then the surgeon closes the ends of the aorta with stitches.
Expectations (prognosis)
Surgery can treat double aortic arch. Most children feel better right after surgery, although some may continue to have breathing symptoms.
In rare cases, if the arch is pressing down very hard on the airway, the child can have severe breathing difficulty that leads to death.
Complications
Calling your health care provider
Call your health care provider if your infant has symptoms of double aortic arch.
References
Park MK. Park: Pediatric Cardiology for Practitioners. 5th ed. Philadelphia, Pa: Mosby; 2008.
Bernstein D. Other congenital heart and vascular malformations. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Behrman: Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders; 2011:chap 426.
Townsend Jr. CM, Beauchamp RD, Evers BM, Mattox KL. Townsend: Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders; 2008.
Review Date: 2/7/2012
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine; and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Aortic arch anomaly; Double arch
Prevention
There is no known way to prevent this condition.
References
Park MK. Park: Pediatric Cardiology for Practitioners. 5th ed. Philadelphia, Pa: Mosby; 2008.
Bernstein D. Other congenital heart and vascular malformations. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Behrman: Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders; 2011:chap 426.
Townsend Jr. CM, Beauchamp RD, Evers BM, Mattox KL. Townsend: Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders; 2008.
Review Date: 2/7/2012
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine; and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 2/7/2012
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine; and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.