Skip to main content
SpringerLink
Log in

The right-sided aortic arch in children with esophageal atresia and tracheo-esophageal fistula: a repair through the right thoracotomy

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Purpose

The management of the esophageal atresia and tracheo-esophageal fistula (EA/TEF) with right-sided aortic arch (RAA) is controversial. The preoperative diagnostic techniques may fail to show RAA associated with EA/TEF. Surgeon may need to make a decision to change the side of thoracotomy. The aim of the current study was to evaluate the possibility of preoperative diagnosis of RAA and the primary anastomosis through right chest.

Methods

A retrospective review was performed in EA/TEF patients between February 2001 and 2008. A total of 79 patients (35 female, 44 male) with EA/TEF were reviewed. Eleven (13%) patients (5 female, 6 male) had an RAA. Echocardiography was performed in 10 of 11 patients with RAA. The chest was accessed through the right side in all patients.

Results

The incidence of RAA was found to be higher in our study than previous studies (13%). Right thoracotomy was performed successfully in all patients. Three patients died due to multiple congenital anomalies and 1 patient due to bleeding postoperatively. Five of 10 had normal echocardiography findings. Only one patient with RAA has been successfully diagnosed by preoperative echocardiographic examination. Seven patients had no complication after operation. Their follow-up was uneventful.

Conclusion

Preoperative recognition of RAA with echocardiography is unlikely in patients with EA/TEF but the presence of RAA does not decrease the success rate of EA/TEF repair through the right thoracotomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Myers NA (1986) The history of oesophageal atresia and tracheo-oesophageal fistula 1670–1984. Prog Pediatr Surg 20:106–157

    PubMed  CAS  Google Scholar 

  2. Allen SR, Ignacio R, Falcone RA (2006) The effect of a right-sided aortic arch on outcome in children with esophageal atresia and tracheoesophageal fistula. J Pediatr Surg 41:479–483. doi:10.1016/j.jpedsurg.2005.10.051

    Article  PubMed  Google Scholar 

  3. Babu R, Spitz PL, Drake DP (2000) The management of oesophageal atresia in neonates with right-sided aortic arch. J Pediatr Surg 35:56–58

    Article  PubMed  CAS  Google Scholar 

  4. Harrison MR, Hanson BA, Mahour GH (1977) The significance of right aortic arch in repair of esophageal atresia and tracheooesophageal fistula. J Pediatr Surg 12:861–869. doi:10.1016/0022-3468(77)90595-4

    Article  PubMed  CAS  Google Scholar 

  5. O’neill JA, Rowe MI, Grosfeld JL (eds) (1998) Congenital anomalies of the esophagus. In: Pediatric surgery, 5th edn, vol 2. Mosby, St. Louis, pp 941–967

  6. Shenoy VG, Jawale SA, Oak SN (2001) Esophageal atresia with distal tracheoesophageal fistula associated with situs inversus. Pediatr Surg Int 17:538–539. doi:10.1007/s003830000542

    Article  PubMed  CAS  Google Scholar 

  7. Zidere V, Tsapakis EG, Huggon IC (2006) Right aortic arch in the fetus. Ultrasound Obstet Gynecol 28:876–881. doi:10.1002/uog.3841

    Article  PubMed  CAS  Google Scholar 

  8. Bowkett B, Beasley SW, Myers NA (1999) The frequency, significance, and management of a right aortic arch in association with esophageal atresia. Pediatr Surg Int 15:28–31. doi:10.1007/s003830050505

    Article  PubMed  CAS  Google Scholar 

  9. Stringel G, Coln D, Guetrin L (1990) Esophageal atresia and right aortic arch. Right or left thoracotomy? Pediatr Surg Int 5:103–105. doi:10.1007/BF00178226

    Article  Google Scholar 

  10. Lillehei CW, Colan S (1992) Echocardiography in the preoperative evaluation of vascular rings. J Pediatr Surg 27:1118–1121. doi:10.1016/0022-3468(92)90571-N

    Article  PubMed  CAS  Google Scholar 

  11. Harrison MR, Weitzman JJ, Delorimier AA (1980) Localisation of the aortic arch prior to repair of esophageal atresia. J Pediatr Surg 15:312. doi:10.1016/S0022-3468(80)80144-8

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Ondokuz Mayis University, Samsun, Turkey

    Unal Bicakci, Burak Tander, Ender Ariturk, Riza Rizalar, Suat H. Ayyildiz & Ferit Bernay

Authors
  1. Unal Bicakci
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Burak Tander
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ender Ariturk
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Riza Rizalar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Suat H. Ayyildiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ferit Bernay
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Burak Tander.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bicakci, U., Tander, B., Ariturk, E. et al. The right-sided aortic arch in children with esophageal atresia and tracheo-esophageal fistula: a repair through the right thoracotomy. Pediatr Surg Int 25, 423–425 (2009). https://doi.org/10.1007/s00383-009-2354-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-009-2354-6

Keywords

Search

Navigation