Descending aortic translocation for aerodigestive vascular compression.
- 1Department of Cardiac Surgery, Boston Children's Hospital, Boston, Mass.
- 2Department of Cardiology, Boston Children's Hospital, Boston, Mass.
- 3Department of Surgery, Boston Children's Hospital, Boston, Mass.
Abstract
Objective
Patients with complex vascular ring anomalies can present with symptoms of esophageal and airway compression, occasionally persisting despite relief of the vascular ring, due to residual compression from the aorta. We report our early experience with descending aortic translocation to address aerodigestive vascular compression.Methods
This is a retrospective single-center review of patients undergoing descending aortic translocation. The operation involves dividing the distal aortic arch on cardiopulmonary bypass, relocating the descending aorta beneath the carina and right pulmonary artery, and anastomosis to the posterior aspect of the ascending aorta, thereby entirely relieving compression on the aerodigestive tract. Concomitant esophageal mobilization and tracheopexies are performed as needed.Results
From 2020 to 2023, 15 patients underwent descending aortic translocation. Anatomic variants included hairpin aorta (n = 2), circumflex aorta (n = 4), midline descending aorta (n = 7), and bowstring aorta (n = 2). Median age was 2 years. Preoperatively, most patients (80%) had mixed esophageal and airway symptoms and had undergone at least 1 prior operation (60%). Intraoperative bronchoscopy revealed improved airway patency for all patients. Postoperatively, 93% of patients had relief of respiratory symptoms, and 79% of patients had improved dysphagia. Postoperative complications included neurologic event (n = 1) with full resolution, right pulmonary artery compression requiring stenting (n = 1), and need for reoperation (n = 2).Conclusions
Descending aortic translocation is a novel approach that can provide symptomatic relief of aerodigestive compression related to complex aortic anomalies. For patients with persistent symptoms after initial vascular ring repair, ongoing aortic compression may need to be addressed, thus also raising the question of whether descending aortic translocation should be considered as a first-line therapy.
Related
- Left Anterior Descending Coronary Artery Compression After Harmony Transcatheter Pulmonary Valve Implantation
- A neonatal extra-anatomical bypass for a “corkscrew” descending aorta associated with interrupted right aortic arch
- Aortopulmonary Fistula Complicating a Ruptured Infected Proximal Descending Thoracic Aortic Pseudoaneurysm.
- Case Report: staged segment-specific open and endovascular treatment of chronic post-dissection aortic disease with descending thoracic and giant infrarenal aneurysmal components
- Quality of life after open descending thoracic and thoracoabdominal aortic repair: A prospective cohort study.
BibTeX
@article{tsou2026descending,
title = {{Descending aortic translocation for aerodigestive vascular compression.}},
author = {Sarah Tsou and Peter Chiu and Ryan Benavente and Daniel Castellanos and Jennifer Brown and Lianne Cole and Benjamin Zendejas and Christopher W Baird},
journal = {JTCVS open},
year = {2026},
month = jun,
doi = {10.1016/j.xjon.2026.101888},
url = {https://europepmc.org/article/MED/42948110},
note = {CC BY},
}
RIS
TY - JOUR
TI - Descending aortic translocation for aerodigestive vascular compression.
AU - Sarah Tsou
AU - Peter Chiu
AU - Ryan Benavente
AU - Daniel Castellanos
AU - Jennifer Brown
AU - Lianne Cole
AU - Benjamin Zendejas
AU - Christopher W Baird
PY - 2026
DA - 2026/06/05
JO - JTCVS open
DO - 10.1016/j.xjon.2026.101888
UR - https://europepmc.org/article/MED/42948110
AB - Objective Patients with complex vascular ring anomalies can present with symptoms of esophageal and airway compression, occasionally persisting despite relief of the vascular ring, due to residual compression from the aorta. We report our early experience with descending aortic translocation to address aerodigestive vascular compression.Methods This is a retrospective single-center review of patients undergoing descending aortic translocation. The operation involves dividing the distal aortic arch on cardiopulmonary bypass, relocating the descending aorta beneath the carina and right pulmonary artery, and anastomosis to the posterior aspect of the ascending aorta, thereby entirely relieving compression on the aerodigestive tract. Concomitant esophageal mobilization and tracheopexies are performed as needed.Results From 2020 to 2023, 15 patients underwent descending aortic translocation. Anatomic variants included hairpin aorta (n = 2), circumflex aorta (n = 4), midline descending aorta (n = 7), and bowstring aorta (n = 2). Median age was 2 years. Preoperatively, most patients (80%) had mixed esophageal and airway symptoms and had undergone at least 1 prior operation (60%). Intraoperative bronchoscopy revealed improved airway patency for all patients. Postoperatively, 93% of patients had relief of respiratory symptoms, and 79% of patients had improved dysphagia. Postoperative complications included neurologic event (n = 1) with full resolution, right pulmonary artery compression requiring stenting (n = 1), and need for reoperation (n = 2).Conclusions Descending aortic translocation is a novel approach that can provide symptomatic relief of aerodigestive compression related to complex aortic anomalies. For patients with persistent symptoms after initial vascular ring repair, ongoing aortic compression may need to be addressed, thus also raising the question of whether descending aortic translocation should be considered as a first-line therapy.
SN - 2666-2736
ER -