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Pediatric airway compression in aortic arch malformations: a multidisciplinary approach

BACKGROUND: Aortic arch malformations (AAMs) should be suspected in the presence of persistent respiratory symptoms despite medical treatment or feeding problems at the pediatric age. AIM: We report a descriptive cohort of patients with AAMs and the local management protocol applied. METHODS: A tota...

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Autores principales: Petreschi, Francesca, Coretti, Antonella, Porcaro, Federica, Toscano, Alessandra, Campanale, Cosimo Marco, Trozzi, Marilena, Secinaro, Aurelio, Allegorico, Annalisa, Cutrera, Renato, Carotti, Adriano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10401269/
https://www.ncbi.nlm.nih.gov/pubmed/37547103
http://dx.doi.org/10.3389/fped.2023.1227819
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author Petreschi, Francesca
Coretti, Antonella
Porcaro, Federica
Toscano, Alessandra
Campanale, Cosimo Marco
Trozzi, Marilena
Secinaro, Aurelio
Allegorico, Annalisa
Cutrera, Renato
Carotti, Adriano
author_facet Petreschi, Francesca
Coretti, Antonella
Porcaro, Federica
Toscano, Alessandra
Campanale, Cosimo Marco
Trozzi, Marilena
Secinaro, Aurelio
Allegorico, Annalisa
Cutrera, Renato
Carotti, Adriano
author_sort Petreschi, Francesca
collection PubMed
description BACKGROUND: Aortic arch malformations (AAMs) should be suspected in the presence of persistent respiratory symptoms despite medical treatment or feeding problems at the pediatric age. AIM: We report a descriptive cohort of patients with AAMs and the local management protocol applied. METHODS: A total of 59 patients with AAM were retrospectively reviewed. Three groups were identified: double aortic arch (DAA), group 1; complete vascular ring (non-DAA), group 2; and anomalous origin of the innominate artery (IA), group 3. RESULTS: Prenatal diagnosis was available for 62.7% of the patients. In all, 49.2% of children were symptomatic. There was a significantly different prevalence of respiratory symptoms within the three groups: 73.7% in group 1, 24.2% in group 2, and 100% in group 3 (p-value: <0.001). Surgery was considered in the presence of symptoms in patients with DAA and in those with reduction of the tracheal section area greater than 50%. A total of 52.5% of the patients underwent surgical repair (median age 6 months). The median follow-up interval was 21.9 months. Respiratory symptoms improved in most symptomatic patients. CONCLUSIONS: No specific protocols are available for the management of patients with AAMs. Conservative treatment seems to be reasonable for asymptomatic patients or those with airway stenosis less than 50%. A close follow-up is necessary to identify early patients who become symptomatic.
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spelling pubmed-104012692023-08-05 Pediatric airway compression in aortic arch malformations: a multidisciplinary approach Petreschi, Francesca Coretti, Antonella Porcaro, Federica Toscano, Alessandra Campanale, Cosimo Marco Trozzi, Marilena Secinaro, Aurelio Allegorico, Annalisa Cutrera, Renato Carotti, Adriano Front Pediatr Pediatrics BACKGROUND: Aortic arch malformations (AAMs) should be suspected in the presence of persistent respiratory symptoms despite medical treatment or feeding problems at the pediatric age. AIM: We report a descriptive cohort of patients with AAMs and the local management protocol applied. METHODS: A total of 59 patients with AAM were retrospectively reviewed. Three groups were identified: double aortic arch (DAA), group 1; complete vascular ring (non-DAA), group 2; and anomalous origin of the innominate artery (IA), group 3. RESULTS: Prenatal diagnosis was available for 62.7% of the patients. In all, 49.2% of children were symptomatic. There was a significantly different prevalence of respiratory symptoms within the three groups: 73.7% in group 1, 24.2% in group 2, and 100% in group 3 (p-value: <0.001). Surgery was considered in the presence of symptoms in patients with DAA and in those with reduction of the tracheal section area greater than 50%. A total of 52.5% of the patients underwent surgical repair (median age 6 months). The median follow-up interval was 21.9 months. Respiratory symptoms improved in most symptomatic patients. CONCLUSIONS: No specific protocols are available for the management of patients with AAMs. Conservative treatment seems to be reasonable for asymptomatic patients or those with airway stenosis less than 50%. A close follow-up is necessary to identify early patients who become symptomatic. Frontiers Media S.A. 2023-07-21 /pmc/articles/PMC10401269/ /pubmed/37547103 http://dx.doi.org/10.3389/fped.2023.1227819 Text en © 2023 Petreschi, Coretti, Porcaro, Toscano, Campanale, Trozzi, Secinaro, Allegorico, Cutrera and Carotti. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Petreschi, Francesca
Coretti, Antonella
Porcaro, Federica
Toscano, Alessandra
Campanale, Cosimo Marco
Trozzi, Marilena
Secinaro, Aurelio
Allegorico, Annalisa
Cutrera, Renato
Carotti, Adriano
Pediatric airway compression in aortic arch malformations: a multidisciplinary approach
title Pediatric airway compression in aortic arch malformations: a multidisciplinary approach
title_full Pediatric airway compression in aortic arch malformations: a multidisciplinary approach
title_fullStr Pediatric airway compression in aortic arch malformations: a multidisciplinary approach
title_full_unstemmed Pediatric airway compression in aortic arch malformations: a multidisciplinary approach
title_short Pediatric airway compression in aortic arch malformations: a multidisciplinary approach
title_sort pediatric airway compression in aortic arch malformations: a multidisciplinary approach
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10401269/
https://www.ncbi.nlm.nih.gov/pubmed/37547103
http://dx.doi.org/10.3389/fped.2023.1227819
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