Truncus Arteriosus and Double Aortic Arch
Aneonate had respiratory distress with stridor but no laryngeal anomaly at fibroscopy. Oral transit with a contrast medium showed a posterior compression of the trachea, suggesting a vascular origin. Aggravation occurred at 1 month of age, leading to intubation and assisted ventilation.
Echocardiography diagnosed a truncus arteriosus, but no vascular ring could be seen. A CT scan was then performed for additional anatomic information. A multislice CT (Volume Zoom, Siemens) scan procedure was performed with 4×2.5-mm iodine-enhanced slice acquisitions, accounting for a total scan time of 4 seconds. Three-dimensional reconstructions using a volume-rendering technique showed 2 congenital vessel anomalies, the origin of main pulmonary artery arising from the left side of aorta and a double aortic arch (Figure 1). A left oblique anterior view with 3D rendering technique showed the vascular ring with a right-sided descending aorta (Figure 2).
The patient underwent surgical repair of the truncus arteriosus and division of the left aortic arch. The postoperative course was uneventful with relief of respiratory symptoms.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.