PMC6091004_01
a flow/volume curve at the first pulmonary function test; b flow/volume curve after 1 month of therapy
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Fig1
The pulmonary function tests showed: FEV1 of 2.88 L (85% of predicted), FVC 3.71 L (96% of predicted) with a FEV1/FVC ratio of 77% and an FEV1/PEF ratio > 8, as in cases of intrathoracic obstruction; furthermore, analysis of the flow/volume curve (Fig. 1a) showed a flow plateau of the expiratory curve with an armpit at low pulmonary volumes. A new spirometry showed findings similar to the previous one (Fig. 1b), thus confirming an intrathoracic obstruction.
a CT scan with contrast medium highlighting the presence of a complete Double Aortic Arch (axial and sagittal reconstructions). Red circles indicate the 2 arches surrounding the trachea and esophagus. b Arterial phase CT: 3D reconstructions of the aorta, showing the DAA
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Fig2
The CT demonstrated the presence of a complete double aortic arch (DAA) imprinting both the esophagus and the trachea, causing a greater narrowing in the expiratory phase (Fig. 2).