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During repair of an esophageal atresia with tracheoesophageal fistula(EA/TEF),a right-sided aortic arch(RAA)presents a technical challenge.We reviewed o ur experience with EA/TEF focusing on the impact of RAA.Methods:A retrospectiv e review of patients with EA/TEF at our institution from 1990 to 2004 was perfor med.Of 61 patients,53 had a left aortic arch(LAA)and 8 had RAA.Results:The mean gestational age and birth weight were similar between patients with LAA an d RAA.There were more vascular rings in patients with RAA than with LAA(37.5% vs 3.8%,P =.009).A preoperative echocardiogram correctly identified the loca tion of the arch in all with LAA but only 62.5%of those with RAA.Operative com plications occurred in 25%of patients with RAA and 11%of patients with LAA.Co nclusions:Management of a child with RAA and EA/TEF is technically challenging.Preoperative identification of the great vessel anomalies may impact operative decision making.Therefore,careful diagnostic evaluation of a patient with an a ortic arch that cannot be easily defined by ECHO should be considered before def initive repair.
During repair of an esophageal atresia with tracheoesophageal fistula (EA / TEF), a right-sided aortic arch (RAA) presents a technical challenge. We reviewed the experience with EA / TEF focusing on the impact of RAA. Methods: A retrospectiv e review of patients with EA / TEF at our institution from 1990 to 2004 was performed med. Of 61 patients, 53 had a left aortic arch (LAA) and 8 had RAA. Results: The mean gestational age and birth weight were similar between patients with LAA an d RAA. There were more vascular rings in patients with RAA than with LAA (37.5% vs 3.8%, P = .009). A preoperative echocardiogram correctly identified the loca tion of the arch in all with LAA but only 62.5% of those with RAA .Operative com plications occurred in 25% of patients with RAA and 11% of patients with LAA. Co nclusions: Management of a child with RAA and EA / TEF is technically challenging. Preoperative identification of the great vessel anomalies may impact operative decision making.Therefore, careful diagnostic evaluation of ap atient with an aortic arch that can not be easily defined by ECHO should be considered before def initive repair.