Effect of exercise on asymptomatic children with an isolated aberrant subclavian artery.

OBJECTIVE

An aberrant subclavian artery (aSCA) is the most common congenital anomaly of the aortic arch. Most cases are asymptomatic and found incidentally.This study was conducted to estimate the occult exercise-induced oesophago-tracheal compression (EIETC) in children with isolated aSCA found by screening echocardiography.

METHODS

A total of 42 asymptomatic children with isolated aSCA, aged from 6.8 to 16 years, were studied in 2007. Barium oesophagography, echocardiography and magnetic resonance angiography or computed tomography were used to confirm this anomaly. In order to estimate the occult EIETC, we conducted a protocol of pulmonary function tests (PFTs), a feeding test and a treadmill exercise test (TET) on the patients.

RESULTS

All of the children could be diagnosed by both barium oesophagography and echocardiography. Six (14%) patients had a globus sensation before testing. None had a history of inspiratory stridor, failure to thrive or dysphagia. No complications developed in this study.An additional patient had a globus sensation after TET, but none had dysphagia, chest pain, dizziness or dyspnoea. Response to exercise was normal, feeding tests were normal and there were no significant changes in the results of PFTs or the grade of respiratory impairment after exercise.

CONCLUSIONS

Based on the function tests used, there is no evidence of EIETC and cardiopulmonary deficits in the patients with isolated aSCA. These findings support the known concept not to operate asymptomatic patients with an isolated aSCA found incidentally by screening echocardiography and that there is no increased risk of cardiopulmonary decompensation under defined exercise.