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Thoracoscopic division of an incomplete double aortic arch
MD Traynor, SA Husain, ZJ Kastenberg
University of Utah
Introduction
Thoracoscopic division of vascular rings has been described but more often these are approached via thoracotomy. We present a case of an incomplete double aortic arch with right dominance and tracheal compression. This case was approached thoracoscopically and we would like to highlight the feasibility of this approach.
Case
The patient is a 15 year old female with a chief complaint of shortness of breath. CT angiography demonstrated a double aortic arch with right sided dominance. The patient was placed in right lateral decubitus. Two 12 mm and two 5 mm trocars were inserted. We incised the pleura from the left subclavian artery to the descending aorta. The ligamentum arteriosum was dissection and divided with clips once the recurrent nerve was identified and protected. The left (non-dominant) arch was dissected circumferentially and divided with a vascular load stapler. Pleural drainage was performed.
Conclusion
The patient dismissed on postoperative day 1 and is two months symptom free.
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