Double aortic arch: An uncommon diagnosis presenting with recurrent respiratory symptoms.

Sarah A/Salam Salih, Rayan Saeed Mohamed Khair, Fathia A. Magid, Abdelbasit M.A. Elbashier


A vascular ring is defned as an anomaly of the great arteries (aortic arch and its branches) that compresses the trachea and/or oesophagus. Double aortic arch is one of the most common types of vascular rings.
We present a male newborn infant with double aortic arch who initially presented with inspiratory stridor since birth that was aggravated by crying. He was initially worked up as a case of congenital laryngomalacia.
At 26 days of age, he presented to the emergency department with attacks of cough associated with stridor, interrupted breastfeeding, irritability, cyanosis and apnoea. Investigations were done and the diagnosis
of double aortic arch was made by echocardiography and confrmed by contrast-enhanced computed tomography.
Standard surgical division of ligamentum arteriosum was able to relieve the trachea and the symptoms

Full Text:



Backer CL, Monge MC, Popescu AR et al.

Vascular rings. Semin Pediatr Surg 2016; 25:


Davies M, Guest PJ. Developmental

abnormalities of the great vessels of the thorax

and their embryological basis. Br Jr Radiol

; 76: 491.

Powell AJ, Mandell VS. Vascular rings and

slings. In: Nadas’ Paediatric Cardiology, 2nd,

Kean JF, Lock JE, Fyler DC (Eds), Saunders

Elsevier, Philadelphia 2006; p.811.

Bakker DAH, Berger RMF, Witsenburg M,

et al. Vascular rings: a rare cause of common

respiratory symptoms. Acta Paediatr. 1999;


Mustafa Kir, Gul Sagin Saylam, Ulas Karadas,

et al. Vascular Rings: Presentation, Imaging

Strategies, Treatment, and Outcome. Pediatr

Cardiol 2012; 33: 607–617.

Rekha Krishnasarma, Liza Green Mackintosh,

Francine Bynum. ALTE and feeding intolerance

as a presentation of double aortic arch. Case

Rep Pediatr. 2016; vol.2016: ID8475917.

Humphery C, Duncan K, Fletcher S. Decade

of Experience with Vascular Rings at a Single

Institution. Pediatrics 2006; 117: e903-8

Shen-Hao Lai, Sui-Ling Liao, Kin-Sun Wong.

Cardiovascular-associated tracheobronchial

obstruction in children. Cardiology in the

Young 2013; 23: 233–238.

Alastair Turner, Gil Gavel, Jonathan Coutts.

Vascular rings—presentation, investigation and

outcome. Eur J Pediatr 2005; 164: 266–270.

Francois K, Panzer J, De Groote K et al. Early

and late outcomes after surgical management

of congenital vascular rings. Eur J Paediatr,

; 176; 371-377


  • There are currently no refbacks.

ISSN: 1858-5345