Left aortic arch and aberrant right subclavian artery in children: spectrum of symptoms and response to surgical intervention.

Autor:	Cole L; Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, USA., Brown J; Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts, USA., Yasuda J; Department of Gastroenterology, Boston Children's Hospital, Boston, Massachusetts, USA., Ngo P; Department of Gastroenterology, Boston Children's Hospital, Boston, Massachusetts, USA., Staffa SJ; Department of Anesthesiology, Boston Children's Hospital, Boston, USA., Crilley N; Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts, USA., Chiu P; Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts, USA., Zendejas B; Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, USA., Baird C; Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	Cardiology in the young [Cardiol Young] 2024 Oct 18, pp. 1-7. Date of Electronic Publication: 2024 Oct 18.
DOI:	10.1017/S1047951124026519
Abstrakt:	Background: Children with left aortic arch and aberrant right subclavian artery may present with either respiratory or swallowing symptoms beyond the classically described solid-food dysphagia. We describe the clinical features and outcomes of children undergoing surgical repair of an aberrant right subclavian artery. Materials and Methods: This was a retrospective review of children undergoing repair of an aberrant right subclavian artery between 2017 and 2022. Primary outcome was symptom improvement. Pre- and post-operative questionnaires were used to assess dysphagia (PEDI-EAT-10) and respiratory symptoms (PEDI-TBM-7). Paired t -test and Fisher's exact test were used to analyse symptom resolution. Secondary outcomes included perioperative outcomes, complications, and length of stay. Results: Twenty children, median age 2 years (IQR 1-11), were included. All presented with swallowing symptoms, and 14 (70%) also experienced respiratory symptoms. Statistically significant improvements in symptoms were reported for both respiratory and swallowing symptoms. Paired (pre- and post-op) PEDI-EAT-10 and PEDI-TBM-7 scores were obtained for nine patients, resulting in mean (± SD) scores decreasing (improvement in symptoms) from 19.9 (± 9.3) to 2.4 (± 2.5) p = 0.001, and 8.7 (± 4.7) to 2.8 (± 4.0) p = 0.006, respectively. Reoperation was required in one patient due to persistent dysphagia from an oesophageal stricture. Other complications included lymphatic drainage ( n = 4) and transient left vocal cord hypomobility ( n = 1). Conclusion: Children with a left aortic arch with aberrant right subclavian artery can present with oesophageal and respiratory symptoms beyond solid food dysphagia. A thorough multidisciplinary evaluation is imperative to identify patients who can benefit from surgical repair, which appears to be safe and effective.
Databáze:	MEDLINE
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