The effect of a right-sided aortic arch on outcome in children with esophageal atresia and tracheoesophageal fistula

Steven R. Allen; Romeo Ignacio; Richard A. Falcone; Maria H. Alonso; Rebeccah L. Brown; Victor F. Garcia; Thomas H. Inge; Frederick C. Ryckman; Brad W. Warner; Richard G. Azizkhan; Gregory M. Tiao

doi:10.1016/j.jpedsurg.2005.10.051

The effect of a right-sided aortic arch on outcome in children with esophageal atresia and tracheoesophageal fistula

Steven R. Allen, Romeo Ignacio, Richard A. Falcone, Maria H. Alonso, Rebeccah L. Brown, Victor F. Garcia, Thomas H. Inge, Frederick C. Ryckman, Brad W. Warner, Richard G. Azizkhan, Gregory M. Tiao^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

43 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	479-483
Number of pages	5
Journal	Journal of pediatric surgery
Volume	41
Issue number	3
DOIs	https://doi.org/10.1016/j.jpedsurg.2005.10.051
State	Published - Mar 2006
Externally published	Yes

Keywords

Esophageal atresia
Right-sided aortic arch
Tracheoesophageal fistula

ASJC Scopus subject areas

Surgery
Pediatrics, Perinatology, and Child Health

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10.1016/j.jpedsurg.2005.10.051

Cite this

Allen, S. R., Ignacio, R., Falcone, R. A., Alonso, M. H., Brown, R. L., Garcia, V. F., Inge, T. H., Ryckman, F. C., Warner, B. W., Azizkhan, R. G., & Tiao, G. M. (2006). The effect of a right-sided aortic arch on outcome in children with esophageal atresia and tracheoesophageal fistula. Journal of pediatric surgery, 41(3), 479-483. https://doi.org/10.1016/j.jpedsurg.2005.10.051

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title = "The effect of a right-sided aortic arch on outcome in children with esophageal atresia and tracheoesophageal fistula",

abstract = "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.",

keywords = "Esophageal atresia, Right-sided aortic arch, Tracheoesophageal fistula",

author = "Allen, {Steven R.} and Romeo Ignacio and Falcone, {Richard A.} and Alonso, {Maria H.} and Brown, {Rebeccah L.} and Garcia, {Victor F.} and Inge, {Thomas H.} and Ryckman, {Frederick C.} and Warner, {Brad W.} and Azizkhan, {Richard G.} and Tiao, {Gregory M.}",

year = "2006",

month = mar,

doi = "10.1016/j.jpedsurg.2005.10.051",

language = "English (US)",

volume = "41",

pages = "479--483",

journal = "Journal of pediatric surgery",

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publisher = "W.B. Saunders Ltd",

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T1 - The effect of a right-sided aortic arch on outcome in children with esophageal atresia and tracheoesophageal fistula

AU - Allen, Steven R.

AU - Ignacio, Romeo

AU - Falcone, Richard A.

AU - Alonso, Maria H.

AU - Brown, Rebeccah L.

AU - Garcia, Victor F.

AU - Inge, Thomas H.

AU - Ryckman, Frederick C.

AU - Warner, Brad W.

AU - Azizkhan, Richard G.

AU - Tiao, Gregory M.

PY - 2006/3

Y1 - 2006/3

N2 - 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.

AB - 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.

KW - Esophageal atresia

KW - Right-sided aortic arch

KW - Tracheoesophageal fistula

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The effect of a right-sided aortic arch on outcome in children with esophageal atresia and tracheoesophageal fistula

Abstract

Keywords

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