Anomalías del arco aórtico en pacientes pediátricos: características anatómicas, malformaciones asociadas y factores asociados con la intervención quirúrgica en un centro de referencia nacional del Perú, 2015–2024

Boris Borja-Zapata; Georgette Borja-Urbano

doi:10.59594/iicqp.2026.v4n2.177

Authors

Boris Borja-Zapata Diagnostic Imaging Service, Instituto Nacional de Salud del Niño San Borja, Lima 15037, Peru. https://orcid.org/0000-0002-2507-8563
Georgette Borja-Urbano Faculty of Human Medicine, Universidad Ricardo Palma, Lima 15039, Peru. https://orcid.org/0009-0001-7716-3612

DOI:

https://doi.org/10.59594/iicqp.2026.v4n2.177

Keywords:

Aorta, Thoracic, Computed Tomography Angiography, Heart Defects, Congenital, Thoracic Surgery

Abstract

Objective: To identify the types of aortic arch anomalies, describe associated congenital heart defects and extracardiac malformations, and evaluate factors associated with surgical intervention in pediatric patients treated at the Instituto Nacional de Salud del Niño San Borja during 2015–2024.

Methods: This was a retrospective observational study with an association analysis. Patients with aortic arch anomalies identified by cardiac computed tomography angiography were included. Demographic, anatomic, and clinical variables were recorded. Bivariate analyses and Firth's penalized multivariable logistic regression were performed, and crude odds ratios (ORs) and adjusted odds ratios (aORs) were estimated with their corresponding 95% confidence intervals (95% CIs).

Results: A total of 92 patients were included. The median age was 3 months (interquartile range [IQR]: 1–168 months). The left aortic arch was the most frequent configuration (52.2%), followed by the right aortic arch (44.6%). Hypoplasia was the most common obstructive abnormality (33.7%). Complex congenital heart disease was identified in 53.3% of patients and conotruncal congenital heart disease in 44.6%. Extracardiac malformations were observed in 52.2% of patients, with bronchopulmonary abnormalities being the most frequent (34.8%). Surgical intervention was recorded in 62.0% of cases. In the bivariate analysis, complex congenital heart disease, conotruncal congenital heart disease, and major obstructive aortic arch abnormalities were associated with surgical intervention. In the multivariable analysis, complex congenital heart disease (aOR = 3.98; 95% CI: 1.27–12.47; p = 0.018) and major obstructive aortic arch abnormalities (aOR = 8.16; 95% CI: 1.35–49.22; p = 0.022) remained independently associated with surgical intervention.

Conclusions: In this group of patients, the left aortic arch was the most frequent anatomic configuration, and hypoplasia was the most common obstructive abnormality of the aortic arch. Complex congenital heart disease and extracardiac malformations were frequent findings. Complex congenital heart disease and major obstructive aortic arch abnormalities were independently associated with surgical intervention.

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