Surgical approach with minimally invasive intervention in lusoria dysphagia

Carlos Alcántara-Noguez, Department of Cardiac Surgery, Federico Gómez Children’s Hospital, Mexico City, Mexico
Desireé Leines-Castelán, Department of Cardiac Surgery; Unit of Congenital Malformations, Developmental Biology, and Teratogenesis Laboratory. Federico Gómez Children’s Hospital, Mexico City, Mexico
Aarón E. Buenabad-Hernández, Department of Cardiac Surgery; Unit of Congenital Malformations, Developmental Biology, and Teratogenesis Laboratory. Federico Gómez Children’s Hospital, Mexico City, Mexico
Alejandra Contreras-Ramos, Unit of Congenital Malformations, Developmental Biology, and Teratogenesis Laboratory. Federico Gómez Children’s Hospital, Mexico City, Mexico
Sergio Ruiz-González, Departamento de Cirugía Cardiovascular, Hospital Infantil de México Federico Gómez, Ciudad de México, México
Patricia Romero-Cárdenas, Departamento de Cirugía Cardiovascular, Hospital Infantil de México Federico Gómez, Ciudad de México, México
Alejandro Bolio-Cerdán, Department of Cardiac Surgery, Federico Gómez Children’s Hospital, Mexico City, Mexico

The lusoria artery has a prevalence of 0.5-2% in the general population. The abnormal development of the aortic arch forms vascular rings around the trachea and esophagus, causing pressure on them and leading to characteristic symptoms such as chest pain, difficulty breathing, and/or swallowing. Conventionally, only the subclavian artery was severed to release the esophagus, as done in neonates. However, this can lead to long-term hypotrophy of the thoracic limb. The surgical intervention remains controversial, with limitations, and it is only to be performed when the patient presents with symptoms. In the following two cases, a two-stage minimally invasive approach is described: first, a left lateral minithoracotomy for lusoria artery sectioning, and second, a supraclavicular approach for reimplantation into the right carotid artery.

Keywords: Lusoria dysphagia. Minimally invasive intervention. Aortic arch.