Obstruction of the airway by the aorta: an observation in infants with congenital heart disease

Obstruction of the airway by a dilated aorta was observed in four infants who had complex congenital heart defects as follows: two infants had a tetralogy of Fallot and pulmonary atresia; one infant had a truncus arteriosus type 1 and small branched pulmonary arteries; and one infant had a dextroversion of the heart with a right aortic arch, single atrium, single ventricle, transposition of the great vessels, and severe subpulmonic obstruction. In addition to the extrinsic compression of the airway by the large aorta, intrinsic anomalies of the trachea and at times the main bronchi were observed at autopsy in three of the four infants. The compression of the trachea is readily apparent on lateral radiographs of the chest.