How Far Aortopexy Favors the Outcome of The Doubly-Aortic-Arched Patients

Background:Treatment for various vascular ring malformations remains difficult due to the fact that they need distinct surgical techniques. In this retrospective analysis, we offered our four-year experience with surgical therapy in vascular rings. Objective: We aimed at determining the impact of aortopexy technique in patients with double aortic arch (DAA) on early extubation and improvement in both early and late-term outcomes. Patients and methods: The study involved 30 patients who had surgical therapy for DAA between January 2021 and January 2024. They were divided into two groups: Group (A) included 15 patients who were repaired with aortopexy technique and group (B) included 15 patients who were repaired without aortopexy technique. Results: The patients had a mean age of 41.50 ± 38.61 months and a mean weight of 42.00 ± 63.47 kg at surgery. The most prevalent symptom was a cough. Shortness of breath, trouble swallowing, reflux, and recurring pneumonia follow. We encountered early problems such as cylothorax, pneumothorax, and the requirement for a tracheostomy (due to failure of extubation) in 5 patients (16.66%). Patients experienced no long-term problems, with the exception of one (3.33%) incidence of asthma. However, no pressure was recorded on the patient's trachea. We had no fatality during hospitalizations or the follow-up period. The mean duration of mechanical ventilation (MV) in group (A) patients was 3.10 ± 16.79 hours and 10.00 ± 16.79 hours in group (B) patients (p < 0.001). Conclusion: Vascular rings can appear at different ages and with varied symptoms. But, once the diagnosis was established, surgery was necessary and produced acceptable, uneventful long-term survival outcomes. Aortopexy with repair of DAA was beneficial for early extubation and improvement of tracheomalacia.