Often, a double aortic arch is found during prenatal screening. This can turn a moment of happiness into one of terror. Other parents don’t find out until their child is 3 or 4 and can’t seem to get over a respiratory bug.
No matter what age it’s found at, no one’s prepared to hear that their baby has a congenital heart defect. But most children born with a double aortic arch can fully recover with the right treatment.
At UVA Health Children’s, our pediatric heart specialists deal with the full range of heart conditions. Our heart surgery outcomes are better than the national average. And we offer support for your entire family.
What Is Double Aortic Arch?
The aorta is the main artery (a type of blood vessel) that carries blood from the heart to the rest of the body. Normally, the aorta is a single blood vessel which comes up from the heart and then down towards the stomach. The top part, where it curves, is called the aortic arch.
But if your child has a double aortic arch, they have two arteries instead of one. Both of these vessels arch down. And eventually, they meet and become one blood vessel again. Conditions like this are called “vascular ring” defects because the blood vessels create a ring.
Those two blood vessels, or the ring, surround and put pressure on your child’s airway(trachea) and food pipe (esophagus). This can make breathing and eating difficult. How difficult it is depends on your child’s arch. If the left side is larger than the right side, the symptoms will be more noticeable.
Double Aortic Arch Symptoms:
- Noisy breathing (called stridor)
- Barking cough
- Trouble swallowing (dysphagia)
- Trouble gaining weight (sometimes called failure to thrive)
- Reflux
- Chest pain
- Heart murmur
- Many respiratory infections
While most of these first show up in infancy, sometimes it takes a while to notice them. Difficulty swallowing, for example, doesn’t really start before babies are eating solid food.
Diagnosing Double Aortic Arch
Often, double aortic arch is diagnosed during prenatal ultrasounds. If we see that your baby’s double aortic arch is unlikely to cause symptoms, we’ll delay surgery until they’re 6-9 months old.
Because double aortic arch is often found with other heart defects, we’ll want to do additional prenatal testing, including a fetal echo. This lets us see how well your child’s heart is working.
Sometimes, a double aortic arch isn’t caught until after your child is born. Or sometimes not until the age of 3. Rarely, it’s not caught until the teenage years or adulthood. If your child’s pediatrician notices them struggling to eat and breathe, they may refer them to us for heart testing.
At UVA Health Children’s, we have access to advanced imaging that’s designed for kids.
- Chest x-ray
- CT scan
- MRI scan
Sometimes we may also do an echocardiogram. This won’t help detect a double aortic arch. But it can help us detect any other heart defects that might be happening at the same time.
Double Aortic Arch Treatment
No one wants to hear that their child needs heart surgery. But the procedure to repair a double aortic arch is very safe. And our pediatric heart surgeons have extensive experience with even the tiniest hearts.
A small cut will be made on your child’s side. From there, surgeons will tie off the smaller of the two arches. Then, it will be sewn closed and removed.
The immediate effects are less compression on your child’s esophagus and trachea. Which means easier breathing and eating. But they’ll also feel tired from the medications we give during surgery. We’ll keep your child in the hospital until we’re sure they’re ready to go home.
Follow-Up for Double Aortic Arch
If your child’s double aortic arch was found along with other congenital heart defects, or other conditions like a cleft palate, we may recommend genetic testing. Sometimes, a genetic condition can be the cause of a double aortic arch.
After surgery, you’ll follow-up with our cardiology department until your child is completely healed from surgery.
Double Aortic Arch FAQs
When your child has a problem with their heart, it’s normal to have questions. While we can’t predict every question you’ll have, here are some of the most common. Please reach out through MyChart or call our clinic if you have more questions we can help you answer.
What if we decide not to do surgery for my child’s double aortic arch?
Surgery is scary for any parent. But surgery is the best way to ensure that your child has the best outcomes. Even a little difficulty breathing for your entire life can be very challenging. It’s also possible for the pressure on the trachea to build, leading to long-term complications.
Why did this happen to my child?
Most of the time, we don’t know what causes a double aortic arch.
Sometimes, a double aortic arch is caused by a genetic condition. If your child has other symptoms, we’ll refer them for genetic testing. If they do have a condition, we’ll talk to you and your partner about carrier screening.
What will the rest of my child’s life be like?
Congenital heart defects are actually the most common birth defect. 1% of all births have at least 1 heart defect. But for most kids, once that defect is repaired, it doesn’t have any ongoing impact on their life.
Why should I get my child’s double aortic arch repaired at UVA Health Children’s?
In Virginia, UVA Health Children’s leads the way in heart surgery outcomes for children. Our kids get better faster and with fewer complications. As Virginia's #1 children’s hospital, we also have the resources to care for your whole family. Whether you’re looking for nearby housing during recovery or need help explaining your child’s surgery to them or a sibling, we can help.
