Presentation
Congenital cardiac defect. Bronchoscopy revealed a tracheal narrowing inferior to the vocal cords - rule out vascular ring.
Patient Data
Age: 5 days
Gender: Male
From the case:
Double outlet right ventricle
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- enlarged heart, in particular, the right atrium and ventricle
- aortic and main pulmonary artery origin from the right ventricle
- large ventricular septal defect
- right aortic arch with a right-sided descending aorta
- common origin of the left pulmonary artery and the left brachiocephalic artery bifurcating into the left subclavian and left common carotid artery from the aortic arch
- separate aortic origins of the right common carotid artery and right subclavian artery afterwards
- patent ductus arteriosus
- decreased diameter of the trachea at the left brachiocephalic trunk (2.7 mm vs 4.3 mm proximally and distally) indicating compression
- normal lung configuration
- normal drainage of pulmonary veins into the left atrium
- Kerley B lines in both lungs, suggestive of left heart insufficiency
- nutmeg appearance of the liver, suggestive of right heart insufficiency
Case Discussion
Double outlet RV, large VSD, PDA, right-sided aortic arch with mirror-image branching
and left pulmonary artery from the aortic arch.
Pressure exerted on the trachea from a branching vascular ring.
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