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  • Title: The effect of a right-sided aortic arch on outcome in children with esophageal atresia and tracheoesophageal fistula.
    Author: Allen SR, Ignacio R, Falcone RA, Alonso MH, Brown RL, Garcia VF, Inge TH, Ryckman FC, Warner BW, Azizkhan RG, Tiao GM.
    Journal: J Pediatr Surg; 2006 Mar; 41(3):479-83. PubMed ID: 16516619.
    Abstract:
    UNLABELLED: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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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