Vascular Anomalies Associated with Esophageal Atresia and Tracheoesophageal Fistula.

Détails

ID Serval
serval:BIB_735CA03C7A33
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Vascular Anomalies Associated with Esophageal Atresia and Tracheoesophageal Fistula.
Périodique
Journal of Pediatrics
Auteur(s)
Berthet S., Tenisch E., Miron M.C., Alami N., Timmons J., Aspirot A., Faure C.
ISSN
1097-6833 (Electronic)
ISSN-L
0022-3476
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
166
Numéro
5
Pages
1140-1144.e2
Langue
anglais
Résumé
OBJECTIVE: To report the incidence of congenital vascular anomalies in a cohort of patients with esophageal atresia (EA) and tracheoesophageal fistula (TEF) while describing the clinical presentation, diagnosis, and consequences, and to evaluate the diagnostic value of esophagram in diagnosing an aberrant right subclavian artery (ARSA).
METHODS: All patients born with EA/TEF between 2005 and 2013 were studied. Preoperative echocardiography reports, surgical descriptions of primary esophageal repair, and esophagrams were reviewed retrospectively.
RESULTS: Of the 76 children born with EA/TEF included in this study, 14 (18%) had a vascular malformation. The incidence of a right aortic arch (RAA) was 6% (5 of 76), and that of an aberrant right subclavian artery (ARSA) was 12% (9 of 76). RAA was diagnosed in the neonatal period by echocardiography (4 of 5) or surgery (1 of 5), and ARSA was diagnosed by echocardiography (7 of 9) or later on the esophagram (2 of 9). Respiratory and/or digestive symptoms occurred in 9 of the 14 patients with vascular malformation. Both long-gap EA and severe cardiac malformations necessitating surgery were significantly associated with vascular anomalies (P<.05). The sensitivity of the esophagram for diagnosing ARSA was 66%, the specificity was 98%, the negative predictive value was 95%, and the positive predictive value was 85%.
CONCLUSION: ARSA and RAA have an incidence of 12% and 6% respectively, in patients with EA/TEF. A computed tomography angioscan is recommended to rule out such malformations when stenting of the esophagus is indicated, before esophageal replacement surgery, and when prolonged (>2 weeks) use of a nasogastric tube is considered.
Mots-clé
Aorta, Thoracic/abnormalities, Child, Child, Preschool, Echocardiography, Esophageal Atresia/complications, Esophagus/abnormalities, Female, Humans, Male, Predictive Value of Tests, Reproducibility of Results, Retrospective Studies, Sensitivity and Specificity, Subclavian Artery/pathology, Tracheoesophageal Fistula/complications, Vascular Malformations/complications
Pubmed
Création de la notice
27/04/2016 15:58
Dernière modification de la notice
20/08/2019 14:31
Données d'usage