A 1-day-old neonate with esophageal atresia is scheduled for surgery. Preoperative echocardiography reveals a large ventricular septal defect and a right-sided aortic arch. How does a right-sided aortic arch influence the surgical approach for TEF repair?
- A It does not change the surgical approach
- B A right thoracotomy is preferred ✓
- C A left thoracotomy is preferred
- D Median sternotomy is mandatory
Correct answer: B. A right thoracotomy is preferred
Explanation
When a right-sided aortic arch is present, a right thoracotomy is preferred for repair of esophageal atresia with tracheoesophageal fistula. The approach is generally contralateral to the side of the aortic arch to allow optimal exposure and safe ligation of the fistula and esophageal anastomosis.
Reference: Coran's Pediatric Surgery, 7th ed.
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