INoEA 2025 7th International Conference on Esophageal Atresia & 11th International PAAFIS Symposium & Aerodigestive Society Meeting

Introduction:
Double aortic arch (DAA) is a rare congenital vascular anomaly characterized by two aortic arches forming a complete vascular ring that encircles the trachea and/or esophagus, leading to compression and associated symptoms.

Aim:
This study aims to summarize the diagnostic and surgical management experience of children with congenital double aortic arch.

Materials and Methods:
A retrospective review was conducted on the clinical data of children diagnosed and treated for DAA between 1987 and 2024.

Results:
Thirteen patients were included in the study, with 70% being male. The median age at diagnosis was 11.8 months (range: 2–27 months), and the median delay between symptom onset and diagnosis was 14 months. Respiratory symptoms were universal, with stridor observed in 10 of the 13 patients. Gastrointestinal symptoms were reported in 5 cases.

Chest X-rays showed pulmonary infections in all patients and the absence of the aortic knob on the left in 2 cases. Upper gastrointestinal studies revealed a double esophageal impression in 6 cases and a single impression in 3 cases. CT angiography confirmed the diagnosis of DAA in 11 patients.

All patients underwent surgical treatment. Thoracotomy was performed in 7 cases, while thoracoscopy was used in 6 cases. Postoperative outcomes were satisfactory in 9 patients, with mild recurrence of symptoms observed in 2 cases. One patient succumbed postoperatively. No late reoperations were required.

Conclusion:
CT angiography plays a crucial role in the diagnosis of DAA. Thoracoscopy has emerged as a valuable minimally invasive approach for surgical treatment. Overall, surgical outcomes for DAA are excellent, with most patients experiencing significant improvement postoperatively