PT - JOURNAL ARTICLE AU - Trisha V Vigneswaran AU - Milou PM Van Poppel AU - Benedict Griffiths AU - Paul James AU - Haran Jogeesvaran AU - Zehan Rahim AU - John M Simpson AU - Simone Speggiorin AU - Vita Zidere AU - Andrew Nyman TI - Postnatal impact of a prenatally diagnosed double aortic arch AID - 10.1136/archdischild-2020-318946 DP - 2021 Jun 01 TA - Archives of Disease in Childhood PG - 564--569 VI - 106 IP - 6 4099 - http://adc.bmj.com/content/106/6/564.short 4100 - http://adc.bmj.com/content/106/6/564.full SO - Arch Dis Child2021 Jun 01; 106 AB - Background A double aortic arch (DAA) is increasingly identified before birth; however, there are no published data describing the postnatal outcome of a large prenatal cohort.Objective To describe the associations, symptoms and impact of prenatally diagnosed DAA.Methods Retrospective review of consecutive cases seen at two fetal cardiology units from 2014 to 2019. Clinical records including symptoms and assessment of tracheobronchial compression using flexible bronchoscopy were reviewed. Moderate–severe tracheal compression was defined as >75% occlusion of the lumen.Results There were 50 cases identified prenatally and 48 with postnatal follow-up. Array comparative genomic hybridisation (aCGH) was abnormal in 2/50 (4%), aCGH was normal in 33/50 (66%) and of those reviewed after birth, 13 were phenotypically normal. After birth, there was a complete DAA with patency of both arches in 8/48 (17%) and in 40/48 (83%) there was a segment of the left arch which was a non-patent, ligamentous connection.Stridor was present in 6/48 (13%) on the day of birth. Tracheo-oesophageal compressive symptoms/signs were present in 31/48 (65%) patients at median age of 59 days (IQR 9–182 days). Tracheal/carinal compression was present in 40/45 (88%) cases. Seven of 17 (41%) asymptomatic cases demonstrated moderate–severe tracheal compression. All morphologies of DAA caused symptoms and morphology type was not predictive of significant tracheal compression (p=0.3).Conclusions Genetic testing should be offered following detection of double aortic arch. Early signs of tracheal compression are common and therefore delivery where onsite neonatal support is available is recommended. Significant tracheal compression may be present even in the absence of symptoms.No data are available.