Double innominate vein in a case with double aortic arch: a case report.

IF 1.5 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiothoracic Surgery Pub Date : 2024-10-22 DOI:10.1186/s13019-024-03034-w
Hiroki Ishii, Mika Saito, Tomomi Uyeda, Yuta Kuwahara
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Abstract

Background: Double aortic arch (DAA) is a type of vascular ring, causing stridor and dysphagia owing to compression of the trachea and esophagus. In contrast, double innominate veins, which is a relatively rare venous anomaly, usually does not cause symptoms or require intervention.

Case presentation: A 2 month-old boy presented with mild stridor and a hoarse voice while crying, and was diagnosed as having DAA, small atrial septal defects and double innominate vein. The double innominate veins, crossing over and underneath the ascending aorta, did not contribute to airway compression. To release the narrow vascular ring caused by the DAA, surgical resection of the atretic side of the arch was performed by lateral thoracostomy at 4 months of age, before the appearance of signs of bronchomalacia. The double innominate veins were left untouched, and open-heart surgery was avoided.

Conclusions: DAA should be suspected if airway symptoms are present in early infancy, particularly if a right aortic arch is noted. It is important not to hesitate to perform diagnostic imaging and release the DAA, as this might prevent or minimize airway complications. However, for double innominate veins, operative release is not necessary unless it interferes with surgical procedures or is causing symptoms.

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双主动脉弓病例中的双腹股沟静脉:病例报告。
背景:双主动脉弓(DAA)是一种血管环,因压迫气管和食道而导致呼吸困难和吞咽困难。相比之下,双腹股沟静脉是一种相对罕见的静脉畸形,通常不会引起症状或需要干预:一名 2 个月大的男孩在哭闹时出现轻微喘息和声音嘶哑,被诊断为患有 DAA、小房室间隔缺损和双腹股沟静脉。双腹股沟静脉穿过升主动脉并位于其下方,不会造成气道受压。为了释放由 DAA 造成的狭窄血管环,在孩子 4 个月大时,即支气管畸形症状出现之前,通过侧胸腔造口术对闭锁的弓侧进行了手术切除。手术未触及双腹腔静脉,避免了开胸手术:结论:如果婴儿早期出现气道症状,尤其是发现右主动脉弓,就应该怀疑是 DAA。重要的是,在进行诊断成像和释放 DAA 时不要犹豫,因为这可能会预防或减少气道并发症。不过,对于双侧腹股沟静脉,除非会影响手术操作或导致症状,否则没有必要进行手术松解。
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来源期刊
Journal of Cardiothoracic Surgery
Journal of Cardiothoracic Surgery 医学-心血管系统
CiteScore
2.50
自引率
6.20%
发文量
286
审稿时长
4-8 weeks
期刊介绍: Journal of Cardiothoracic Surgery is an open access journal that encompasses all aspects of research in the field of Cardiology, and Cardiothoracic and Vascular Surgery. The journal publishes original scientific research documenting clinical and experimental advances in cardiac, vascular and thoracic surgery, and related fields. Topics of interest include surgical techniques, survival rates, surgical complications and their outcomes; along with basic sciences, pediatric conditions, transplantations and clinical trials. Journal of Cardiothoracic Surgery is of interest to cardiothoracic and vascular surgeons, cardiothoracic anaesthesiologists, cardiologists, chest physicians, and allied health professionals.
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