Sterlitamak city, Republic of Bashkortostan, Russia.

Double aortic arch is an anomaly of the aortic arch in which two aortic arches form a complete vascular ring around the trachea and esophagus that may compress them and cause severe respiratory and feeding difficulties after birth.

Case report

Following images and videos show a case of double aortic arch with the left ductus arteriosus diagnosed at 20 weeks of an uncomplicated pregnancy.

Images 1, 2: The images 1, 2 represent gray scale and color Doppler images showing the transverse scans of the thorax at the level of the three-vessel trachea view with the left ductus arteriosus and double aortic arch.

PA - pulmonary artery; LDA - left ductus arteriosus; Ao - aorta; LAo - left aortic arch of the doubled aortic arch; RAo - right aortic arch of the doubled aortic arch; SVC - superior vena cava; Tr - trachea.

Videos 1, 2, 3: The video 1 shows normal four-chamber view, ventricular outflow tracts of the heart and aorta with the double arch. Videos 2, 3 show gray scale and color Doppler videos of the three vessel-trachea view, transverse view of the left ductus arteriosus and double aortic arch. 

Videos 4, 5: The videos show 4D color Doppler and TUI imaging of arrangement of the pulmonary artery, left ductus arteriosus and double aortic arch. Note also connection between the left ductus arteriosus and the right aortic arch of the doubled aortic arch.

References

1. Moshe Bronshtein, Inna Naroditsky, Frantisek Grochal. Aortic arch anomalies. TheFetus.net. http://sonoworld.com/TheFetus/page.aspx?id=3355
2. Supriya Jain, MD, Beth Kleiner, MD, Anita Moon-Grady, MD, Lisa K. Hornberger, MD. Prenatal Diagnosis of Vascular Rings. J Ultrasound Med 2010; 29:287–294.
3. Chandrakant R. Patel, MBBS, John R. Lane, MD, Michael L. Spector, MD, Philip C. Smith, MD. Fetal Echocardiographic Diagnosis of Vascular Rings. J Ultrasound Med 2006; 25:251–257.
4. S.-J. Yoo, J.-Y. Min, Y.-H. Lee, K. Roman, E. Jaeggi, J. Smallhorn. Fetal sonographic diagnosis of aortic arch anomalies. Ultrasound Obstet Gynecol 2003; 22: 535–546.
5. A.Gul, K.Gungorduk, G.Yildirim, A.Gedikbasi, H.Borna, R.E.Omeroglu. Prenatal sonographic features of persistent right ductus arteriosis with a left aortic arch. Obstetric Case Reports.