[Anomalous subclavian artery: a group of 15 cases]

OBJECTIVE: To report clinical presentation, diagnostic procedures and treatment of patients with anomalous subclavian artery. SUBJECTS: Fifteen patients with anomalous subclavian artery followed up at the Department of Pediatrics, Hospital de Clínicas da Universidade Federal do Paraná. RESULTS: Age at diagnosis varied from birth to eight years, and 10/15 were female. Nine presented with respiratory symptoms (cough, pneumonia, stridor, wheezing). Eleven had gastrointestinal symptoms (vomiting and choking). Six patients have both respiratory and digestive symptoms. Diagnosis was suggested by barium swallow in 14/15; confirmed in 10 by arteriography or helicoidal tomography with vascular reconstruction. In fourteen cases, the anomalous subclavian was at the right side and in one at the left side. Frequent associations were gastroesophageal reflux (6/15), cardiac septum defect and Down syndrome (3/15). Surgical repair was undertaken in eight, two of whom had chylothorax in the immediate post operative period. CONCLUSION: Although anomalous subclavian artery is mostly asymptomatic, it should be looked for in children with respiratory symptoms, mainly cough and choking. The chief investigation tool is barium swallow, and surgical repair is needed when symptoms are present.