Doble arco aórtico en Honduras: causa inusual de disfagia en paciente adulto. Un reporte de caso

Skarleth Paola Bock Alvarado; Andrea Nicole López García; Mónica Isabel Yanes Oviedo; Haroldo Arturo López García

doi:10.47487/apcyccv.v6i2.482

Authors

Skarleth Paola Bock Alvarado Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras. Tegucigalpa, Distrito Central, Francisco Morazán, Honduras. https://orcid.org/0000-0001-7906-5883
Andrea Nicole López García Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras. Tegucigalpa, Distrito Central, Francisco Morazán, Honduras. https://orcid.org/0009-0004-4022-484X
Mónica Isabel Yanes Oviedo Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras. Tegucigalpa, Distrito Central, Francisco Morazán, Honduras. https://orcid.org/0009-0000-2282-9926
Haroldo Arturo López García Departamento de Cardiología, Instituto Nacional Cardiopulmonar, Tegucigalpa, Distrito Central, Francisco Morazán, Honduras; Servicio de Cardiología, Hospital Honduras Medical Center, Tegucigalpa, Francisco Morazán, Honduras. https://orcid.org/0009-0005-9655-0158

DOI:

https://doi.org/10.47487/apcyccv.v6i2.482

Keywords:

Adult, Aortic Arch Syndromes, Cardiovascular Abnormalities, Vascular Rings

Abstract

Vascular rings represent less than 1% of congenital cardiovascular anomalies, with double aortic
arch being the most common variant. It is typically diagnosed in infants, with respiratory symptoms
in over 90% of cases. We present the case of a 31-year-old male patient with recurrent childhood
respiratory infections and asthma, who presented with progressive dysphagia. Contrast-enhanced
computed tomography angiography revealed a double aortic arch with right-sided dominance, and
the esophagram revealed compression of the proximal third of the esophagus. A left posterolateral
thoracotomy was performed with division of the distal left arch, division of the ligamentum arteriosum,
adhesions release, and thoracic aorta reconstruction. Postoperative recovery was favorable, with
complete resolution of symptoms. Double aortic arch is rarely diagnosed in adulthood. This case
highlights its atypical presentation, with predominant gastrointestinal symptoms, and the importance
of considering it in the differential diagnosis of dysphagia.

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References

Priya S, Thomas R, Nagpal P, Sharma A, Steigner M. Congenital anomalies of the aortic arch. Cardiovasc Diagn Ther. 2018;8(Suppl 1):S26-44. doi:10.21037/cdt.2017.10.15

Tanrıverdi DÇ, Şahin M, Onan İS. A rare case: coexistence of double aortic arch and tetralogy of Fallot in a 1-year-old child. Anatol J Cardiol. 2023;27(6):E17-8. doI:10.14744/AnatolJCardiol.2023.3206.

Belkouchi L, Outznit M, El Harras Y, Allali N, Chat L, El Haddad S. Balanced Double Aortic Arch Causing Acute Tracheal Compression. Global Pediatric Health. 2021;8:2333794X211039649.. doi:10.1177/2333794X211039649.

Yahya EH, Kaoutar I, Hounayda J, Rachida L, Youssef O. Double aortic arch (DAA): An unusual cause of dysphagia. Int J Case Rep Images 2021;12:101205Z01EY2021. doi: 10.5348/101205Z01EY2021CR

Acevedo M, Mendoza SE, Fajardo DP, Forero MJ. Doble arco aórtico, falla respiratoria severa neonatal y soporte con oxigenación por membrana extracorpórea. Reporte de caso. Fundación Cardiovascular de Colombia Revista Pediátrica [Internet]. 2022 Jun [citado 2025 Feb 8];1(2) Disponible en: https://www.fcv.org/co/media/ attachments/2022/07/22/ccb---artculo-6-nm-2---rev-ped-fcv-v1.pdf

Tarmahomed A, Umapathi KK. Double aortic arch. En: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [citado 2025 Feb 4]. Disponible en: http://www.ncbi.nlm.nih.gov/books/ NBK558934/

Ruiz V, Deiros L, Uceda Á. Evaluación de doble arco aórtico por ecografía y tomografía computarizada. [imagen clínica]. An Pediatr (Barc). 2019;91(6):419-21. doi: 10.1016/j.anpedi.2018.10.012.

Sahni D, Franklin WH. Vascular ring double aortic arch. En: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [citado 2025 Feb 7]. Disponible en: https://www.ncbi.nlm.nih.gov/books/ NBK558938/

Al-Dairy I, Ibrahim R, Hawat A, Al-Bitar A. Surgical repair of a vascular ring: a frequently misdiagnosed disease. Int J Surg Case Rep. 2025;128:111038. doi: 10.1016/j.ijscr.2025.111038.

Seo JS, Kim DS. Balanced double aortic arch demonstrated by multimodality image and 7-year follow-up in a symptomatic elderly patient: a case report. Radiol Case Rep. 2022;17(11):4399-4402. doi: 10.1016/j.radcr.2022.08.051.

González R, Bustos C, Fuentes A, Yévenes J, Riquelme A, Seguel E, et al. Anillo vascular completo por doble arco aórtico simétrico, una malformación cardiovascular infrecuente. Rev Cir. 2019;71(1):66-69. doi: 10.4067/S2452-45492019000100066.

Temur HO, Yozgat CY, Uzuner S, Ugurlucan M, Yazan H, Cakir E, et al. Balanced double aortic arch causing persistent respiratory symptoms mimicking asthma in an infant. J Pediatr Intensive Care. 2021;10(2):162-166. doi: 10.1055/s-0040-1712959.

Falk CA, Ortega JC, Banegas RM. Aunque usted no lo crea: doble arco aórtico descubierto en búsqueda de un cuerpo extraño. Acta Pediátr Hondu. 2013;4(1):261-266.

Hernández Y, Ortega JC, Avelar IL, Fonseca HF, Banegas RM. Los anillos vasculares, una amenaza creciente para la vía respiratoria. Acta Pediátr Hondu. 2010;1(1):31-36.

Libby P, Bonow RO, Mann DL, Tomaselli G, Bhatt DL, Solomon SD. Braunwald Tratado de Cardiología: texto de medicina cardiovascular. En: Valente A, Dorfman A, Babu-Narayan S, Krieger E, editores. Enfermedad cardiaca congénita en adolescentes y adultos. 12.ª ed. Philadelphia: Elsevier; 2022 p. 1577-1578.