What should I do if I find my child has a right aortic arch?

Right aortic arch is one of the more abnormal symptoms in newborns. It can cause children to have breathing difficulties, swallowing difficulties, repeated respiratory tract infections, slow growth, etc., which has an extremely adverse effect on the child's early development. Therefore, new parents should have a certain understanding of right aortic arch, so that if they find that their children have abnormal conditions due to this disease, they can avoid panic, take reasonable rescue measures, and send their children to the hospital for treatment within the best treatment time. So, what should new parents do after discovering that their child has a right aortic arch? The following is a detailed introduction for you!

Most of the aortic arch is to the left of the trachea and esophagus. The right aortic arch, as the name suggests, means that the aortic arch is located on the right side of the trachea and esophagus. In this case, the aortic arch will run backward and to the left and connect with the descending aorta on the left side of the spine. The direction of the brachiocephalic vessels branches from the right aortic arch is a mirror image of the branches of the normal aortic arch.

When there is a right aortic arch, if the left ductus arteriosus (which closes after birth and becomes the ligamentum arteriosum) or the left subclavian artery (i.e., aberrant left subclavian artery) is emitted from the descending aorta, the ductus arteriosus and the left subclavian artery will run to the left behind the esophagus, thus forming a complete circular vascular structure in space with the right aortic arch, which surrounds the trachea and esophagus and may compress the trachea and esophagus. After birth, the child will experience symptoms such as difficulty breathing, wheezing, recurrent respiratory tract infections, difficulty swallowing, slow eating, and delayed growth and development. This is clinically called a "vascular ring."

For a right aortic arch discovered during the fetal period, it is first necessary to carefully confirm whether there is a malformation of the heart or other organs. If congenital heart disease is present, the chance of concurrent chromosomal abnormalities is also high. The child's future condition mainly depends on the severity of the congenital heart disease and extracardiac malformations. The risk of chromosomal abnormalities is low in patients with an isolated right aortic arch without any intracardiac or extracardiac malformations.

Because the vascular ring caused by the right aortic arch is relatively loose, it will not compress the trachea and esophagus in most cases. It is a normal anatomical structure variation and does not require treatment. In a few cases where compression symptoms occur, compared with other types of vascular rings, symptoms generally appear relatively late, mostly after the age of 1; the symptoms are relatively mild, and in some cases the symptoms may be alleviated or relieved as the child grows. However, if compression symptoms appear within 6 months after the child is born, it indicates that the condition is often more serious and requires active treatment. Treatment is surgical removal of the ductus arteriosus or ligamentum arteriosum. The aberrant left subclavian artery generally does not require treatment, but if there is a tumor-like dilation at its root, there is a risk of severe tracheoesophageal compression and it needs to be treated together. The surgical effect is generally good.