Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492011000100011
Jornal Vascular Brasileiro
Case Report

Duplo arco aórtico: a quebra do silêncio

Double aortic arch: the break of silence

Ana Rita Abrão; Vanessa Queiroz de Souza; Eduardo de Oliveira Campos; Rosangeles Konrad Brito; Alexandre Dias Mançano

Downloads: 2
Views: 1064

Resumo

Anéis vasculares representam 1-2% dos casos das cardiopatias congênitas. Relatamos um caso raro de duplo arco aórtico. Mulher, 60 anos, procurou atendimento na clínica médica apresentando 1 ano de história de disfagia, 6 meses de dispneia e 2 meses de dor torácica esporádica. Raio X de tórax revelou: hiperinsuflação pulmonar difusa, alargamento mediastinal, coração com volume e configurações normais, arco aórtico à direita e alterações degenerativas vertebrais. Tomografia computadorizada do tórax: arco aórtico duplo circundando e comprimindo a traqueia e o esôfago. Arco direito mais calibroso, emergindo dele o tronco braquiocefálico. Do arco esquerdo emergem a artéria carótida comum e a subclávia esquerda. Diagnóstico: anel vascular traqueoesofagiano decorrente do duplo arco aórtico, sendo o arco direito dominante. No presente caso, optou-se por seguimento clínico da paciente, levando-se em conta a intensidade dos sintomas apresentados.

Palavras-chave

Malformações vasculares, anormalidades congênitas, cardiopatias congênitas, aorta torácica

Abstract

Vascular rings represent 1 to 2% of cases of congenital heart disease. We report a rare case of double aortic arch. A 60-year-old woman was admitted to the hospital presenting a one-year history of dysphagia, six months of dyspnea and two months of sporadic chest pain. Radiograph of the chest revealed diffuse pulmonary hyper inflation, widening of the mediastinum, heart of normal size and shape, a right-sized aortic arch, and degenerative changes of the thoracic spine. Computed tomography of the chest showed a double aortic arch encircling and compressing the trachea and the esophagus. The right aortic arch had a larger caliber, with brachiocephalic trunk arising from it. The left common carotid artery and the left subclavian artery arose from the left aortic arch. Diagnosis: tracheoesophageal vascular ring due to double aortic arch, with dominant right arch. In this case, we chose to follow the patient medically, taking into consideration the mildness of the symptoms.

Keywords

Vascular malformations, congenital abnormalities, heart defects, congenital, aorta, thoracic

References

Hardin RE, Brevetti GR, Sanusi M. Treatment of symptomatic vascular rings in the elderly. Tex Heart Inst J. 2005;32:411-5.

Muto A, Nishibe T, Kondo Y, Sato M, Ando M. Detection and treatment of complete vascular ring in an elderly woman with dysphagia. J Thorac Cardiovasc Surg. 2005;130:585-6.

Lowe GM, Donaldson JS, Backer CL. Vascular rings: 10-year review of imaging. Radiographics. 1991;11:637-46.

Yedururi S, Guillerman RP, Chung T. Multimodality imaging of tracheobronchial disorders in children. Radiographics. 2008;28.

Longo-Santos LR, Maksoud-Filho JG, Tannuri U. Vascular rings in childhood: diagnosis and treatment. J Pediatr. 2002;78:244-50.

Backer CL, Mavroudis C, Rigsby CK, Holinger LD. Trends in vascular ring surgery. J Thorac Cardiovasc Surg. 2005;129:1339-47.

Backer CL, Mavroudis C. Congenital Heart Surgery Nomenclature and Database Project: vascular rings, tracheal stenosis, pectus excavatum. Ann Thorac Surg. 2000;69(^s4):S308-18.

Mafeei FHA, Lastoria S, Yoshida WB. Doenças Vasculares Periféricas: o desenvolvimento do sistema vascular. 2002:3-17.

Harty MP, Kramer SS, Fellows KE. Current concepts on imaging of thoracic vascular abnormalities. Curr Opin Pediatr. 2000;12:194-202.

Knight L, Edwards JE. Right aortic arch: Types and associated cardiac anomalies. Circulation. 1974;50:1047-51.

Berdon WE. Rings, slings, and other things: vascular compression of the infant trachea updated from the midcentury to the millennium--the legacy of Robert E. Gross, MD, and Edward B. D. Neuhauser, MD. Radiology. 2000;216:624-32.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5ddfcc8e0e8825cc094ce1d5 jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections