Management of a case of double aortic arch complicated with
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Vascular rings account for 1%–2% of all cardiovascular malformations. Double aortic arch (DAA) accounts for 40% of vascular rings with both functional arches being the rarest, comprising only 5% of cases. We report the perioperative management of a case of codominant DAA with tracheal compression with postoperative tracheal restenosis.

Case Presentation:
A 5-month-old child weighing 6 kg was admitted with complaints of dyspnea and stridor since birth. Two-dimensional (2D) transthoracic echocardiography revealed DAA with patent ductus arteriosus (PDA). Multidetector computed tomography (CT) thorax revealed evidence of DAA forming a complete vascular ring around trachea and esophagus with resultant concentric narrowing of trachea. Right subclavian and common carotid arteries arise from the right aortic arch, and left subclavian and common carotid arteries arise from the left arch with the descending thoracic aorta on the right side. High-resolution CT (HRCT) thorax revealed tracheal narrowing with prestenotic segment measuring 6.6 mm and the narrowest segment measuring 2.5 mm which was 5 mm proximal to the carina...

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