The effect of a right-sided aortic arch on outcome in children with esophageal atresia and tracheoesophageal fistula

Journal of Pediatric Surgery
Steven R AllenGregory M Tiao

Abstract

During repair of an esophageal atresia with tracheoesophageal fistula (EA/TEF), a right-sided aortic arch (RAA) presents a technical challenge. We reviewed our experience with EA/TEF focusing on the impact of RAA. A retrospective review of patients with EA/TEF at our institution from 1990 to 2004 was performed. Of 61 patients, 53 had a left aortic arch (LAA) and 8 had RAA. The mean gestational age and birth weight were similar between patients with LAA and RAA. There were more vascular rings in patients with RAA than with LAA (37.5% vs 3.8%, P = .009). A preoperative echocardiogram correctly identified the location of the arch in all with LAA but only 62.5% of those with RAA. Operative complications occurred in 25% of patients with RAA and 11% of patients with LAA. Management of a child with RAA and EA/TEF is technically challenging. Preoperative identification of the great vessel anomalies may impact operative decision making. Therefore, careful diagnostic evaluation of a patient with an aortic arch that cannot be easily defined by ECHO should be considered before definitive repair.

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Citations

Dec 3, 2014·Seminars in Pediatric Surgery·Andrea ConfortiPietro Bagolan
Mar 10, 2010·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Kenneth K Y Wong, Paul K H Tam
Dec 15, 2012·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·L SahnounA Nouri
Dec 24, 2008·Seminars in Pediatric Surgery·Alan E Mortell, Richard G Azizkhan
May 2, 2009·Pediatrics International : Official Journal of the Japan Pediatric Society·Hasim OlgunNaci Ceviz
Jan 29, 2014·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·D Bouguermouh, A Salem
Feb 11, 2015·Pediatric Radiology·Oliver J Muensterer, Walter E Berdon
Feb 28, 2015·The Journal of Pediatrics·Stéphanie BerthetChristophe Faure
Apr 27, 2011·Journal of cardiovascular ultrasound·Geun Jin HaKee Sik Kim
Jun 10, 2011·Journal of Thoracic Imaging·Jadranka StojanovskaBaskaran Sundaram
Apr 22, 2011·Journal of Pediatric Gastroenterology and Nutrition·Pierre Fayoux, Rony Sfeir

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