{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T12:32:42Z","timestamp":1776169962389,"version":"3.50.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Double aortic arch (DAA) is a rare congenital vascular anomaly resulting in a complete vascular ring that encircles and compresses the trachea and esophagus, leading to respiratory and gastrointestinal symptoms. Accurate diagnosis and timely surgical intervention are essential for symptom relief and preventing complications. However, data on surgical outcomes and long-term follow-up are limited. This study retrospectively analyzed surgical outcomes and perioperative management of DAA to elucidate optimal diagnostic and therapeutic approaches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective cohort study enrolled patients undergoing DAA repair (August 2015\u2013May 2024). Participants were stratified into isolated DAA or DAA with associated intracardiac anomalies groups. Demographic, operative, and outcome variables were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 10 patients undergoing double aortic arch repair, 6 comprised the isolated DAA group (3 males\/3 females; mean age 3.70\u2009\u00b1\u20093.18 months; mean weight 6.28\u2009\u00b1\u20092.77\u2005kg) and 4 had associated intracardiac anomalies (3 males\/1 female; mean age 6.70\u2009\u00b1\u20096.12 months; mean weight 6.15\u2009\u00b1\u20093.59\u2005kg). Isolated DAA patients and those with intracardiac anomalies showed no statistically significant differences in: symptom onset (28.17\u2009\u00b1\u200937.66d vs. 30.50\u2009\u00b1\u200941.96d), anatomic subtypes (dominant right arch 83% vs. 50%), extracardiac anomaly rates (50% vs. 75%), or clinical manifestations\u2014respiratory (67% vs. 100%) and other systemic (17% vs. 75%) (all <jats:italic>P<\/jats:italic>\u2009&amp;gt;\u20090.05). All procedures were successfully completed with significantly shorter operative time in the isolated group (104.83\u2009\u00b1\u200922.23 vs. 233.25\u2009\u00b1\u200938.55\u2005min, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001). No significant intergroup differences (<jats:italic>P<\/jats:italic>\u2009&amp;gt;\u20090.05) were observed in preoperative ventilation, blood loss, ventilator duration, Cardiac Intensive Care Unit stay, drainage duration, hospitalization, or complication rates. During mean 12.7-month follow-up (1\u201336 months), near-complete symptom resolution occurred in 9\/10 survivors, with one death from respiratory failure in a comorbid patient 10 days post-discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Surgical repair of double aortic arch demonstrates acceptable safety and efficacy in both infants and children, with favorable short-to-midterm clinical outcomes regardless of concomitant intracardiac anomalies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2025.1622525","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T05:33:43Z","timestamp":1755149623000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Surgical treatment of double aortic arch in infants"],"prefix":"10.3389","volume":"13","author":[{"given":"Chenhan","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bingjie","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingnan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinwen","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangxian","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liwen","family":"Yi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xicheng","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1053\/j.sult.2011.11.002","article-title":"Multidetector computed tomography of congenital anomalies of the thoracic aorta","volume":"33","author":"Restrepo","year":"2012","journal-title":"Semin Ultrasound CT MR"},{"key":"B2","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1111\/ped.13101","article-title":"Assessment of children with vascular ring","volume":"59","author":"Tola","year":"2017","journal-title":"Pediatr Int Off J Jpn Pediatr Soc"},{"key":"B3","doi-asserted-by":"publisher","first-page":"490","DOI":"10.3760\/cma.j.cn112434-20201026-00483","article-title":"The effect in treatment of congenital double aortic arches without cardiopulmonary bypass","volume":"2022","author":"Zhao","year":"2022","journal-title":"Chin J Thorac Cardiovasc Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1007\/s00595-019-01907-5","article-title":"Congenital vascular ring","volume":"50","author":"Yoshimura","year":"2020","journal-title":"Surg Today"},{"key":"B5","doi-asserted-by":"publisher","first-page":"760523","DOI":"10.3389\/fcvm.2021.760523","article-title":"Importance of acute anterior angulation in double aortic arch needing attention at primary surgery","volume":"8","author":"Beeman","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1007\/s00276-012-1030-z","article-title":"Double aortic arch: an unusual congenital variation","volume":"35","author":"Satyapal","year":"2013","journal-title":"Surg Radiol Anat SRA"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2028","DOI":"10.1002\/ppul.24490","article-title":"The long-term outcome of an isolated vascular ring \u2013 A single-center experience","volume":"54","author":"Depypere","year":"2019","journal-title":"Pediatr Pulmonol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1227819","DOI":"10.3389\/fped.2023.1227819","article-title":"Pediatric airway compression in aortic arch malformations: a multidisciplinary approach","volume":"11","author":"Petreschi","year":"2023","journal-title":"Front Pediatr"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1606","DOI":"10.1016\/j.jacc.2022.02.027","article-title":"Origins and evolution of extracorporeal circulation: JACC historical breakthroughs in perspective","volume":"79","author":"Holman","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"349","DOI":"10.13498\/j.cnki.chin.j.ecc.2024.05.01","article-title":"Expert consensus on improving systemic inflammatory response associated with extracorporeal circulation","volume":"22","author":"Zhang","year":"2024","journal-title":"Chin J Extracorpor Circ"},{"key":"B11","doi-asserted-by":"publisher","first-page":"252","DOI":"10.4070\/kcj.2012.42.4.252","article-title":"Clinical course of vascular rings and risk factors associated with mortality","volume":"42","author":"Suh","year":"2012","journal-title":"Korean Circ J"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1339","DOI":"10.1016\/j.jtcvs.2004.10.044","article-title":"Trends in vascular ring surgery","volume":"129","author":"Backer","year":"2005","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1186\/s12884-020-03300-4","article-title":"Fetal double aortic arch: prenatal sonographic and postnatal computed tomography angiography features, associated abnormalities and clinical outcomes","volume":"20","author":"Guo","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"key":"B14","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1007\/s13244-014-0343-3","article-title":"Computed tomography in the evaluation of vascular rings and slings","volume":"5","author":"Etesami","year":"2014","journal-title":"Insights Imaging"},{"key":"B15","doi-asserted-by":"publisher","first-page":"623","DOI":"10.3892\/etm.2014.1763","article-title":"Clinical value of multi-slice spiral computed tomography angiography and three-dimensional reconstruction in the diagnosis of double aortic arch","volume":"8","author":"Chen","year":"2014","journal-title":"Exp Ther Med"},{"key":"B16","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1186\/s13019-019-0976-x","article-title":"Diagnosis and surgical repair of congenital double aortic arch in infants","volume":"14","author":"Yang","year":"2019","journal-title":"J Cardiothorac Surg"},{"key":"B17","first-page":"1066","volume-title":"Pediatric Cardiac Surgery, Fourth Edition","author":"Constantine","year":"2014"},{"key":"B18","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1007\/s00431-017-2850-y","article-title":"Early and late outcomes after surgical management of congenital vascular rings","volume":"176","author":"Fran\u00e7ois","year":"2017","journal-title":"Eur J Pediatr"},{"key":"B19","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1002\/ppul.23152","article-title":"Congenital vascular rings: a clinical challenge for the pediatrician: congenital vascular rings: a clinical challenge","volume":"50","author":"Licari","year":"2015","journal-title":"Pediatr Pulmonol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s13052-023-01430-x","article-title":"Long term respiratory morbidity in patients with vascular rings: a review","volume":"49","author":"Porcaro","year":"2023","journal-title":"Ital J Pediatr"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.1016\/j.jpedsurg.2008.11.062","article-title":"Follow-up of surgical correction of aortic arch anomalies causing tracheoesophageal compression: a 38-year single institution experience","volume":"44","author":"Ruzmetov","year":"2009","journal-title":"J Pediatr Surg"},{"key":"B22","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1093\/ejcts\/ezab432","article-title":"Long-term outcomes in children undergoing vascular ring division: a multi-institution experience","volume":"61","author":"Yu","year":"2022","journal-title":"Eur J Cardiothorac Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1148\/rg.2017160033","article-title":"Congenital variants and anomalies of the aortic arch","volume":"37","author":"Hanneman","year":"2017","journal-title":"RadioGraphics"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e1336","DOI":"10.1542\/peds.2006-1097","article-title":"Management and outcomes of double aortic arch in 81 patients","volume":"118","author":"Alsenaidi","year":"2006","journal-title":"Pediatrics"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1622525\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T05:33:45Z","timestamp":1755149625000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1622525\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,14]]},"references-count":24,"alternative-id":["10.3389\/fped.2025.1622525"],"URL":"https:\/\/doi.org\/10.3389\/fped.2025.1622525","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,14]]},"article-number":"1622525"}}