Isolated Innominate Artery From the Main Pulmonary Artery in DiGeorge Syndrome

AbstractObjectives:To improve the prenatal diagnosis for anomalous origin of pulmonary artery branches by comparing and analyzing different types of fetal echocardiography features.Methods:Between June 2012 and December 2018, fetal echocardiographic features were analyzed retrospectively from fetuses with a prenatal diagnosis of anomalous origin of pulmonary artery branch. The main points of identification were summarized.Results:A total of 12 fetuses were diagnosed, including anomalous origin of a pulmonary artery branch from the innominate artery and six cases with unilateral absence of pulmonary artery. The shared characteristic sonographic finding was the lack of confluence at the bifurcation of the main pulmonary artery. The differences between the two conditions are highlighted by the origin of the anomalous vessel. In fetuses with anomalous origin of one pulmonary artery branch, the affected pulmonary artery arose from the posterior wall of the ascending aorta as noted on three vessels and trachea view as well as the long axis of the left ventricular outflow tract. This is in contrast to fetuses with unilateral absence of pulmonary artery, where the origin of affected pulmonary artery arises from the base of the innominate artery via the ipsilateral patent arterial duct as evident on the three vessels and trachea view and the coronal view of innominate (brachiocephalic) artery.Conclusion:(1) The main similarity is an absence of a confluence at the bifurcation of the main pulmonary artery. (2) The main distinguishing feature is the origin of the anomalous vessel from either the subclavian or directly from the aorta.

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Reanastomosis and rehabilitation of interrupted left pulmonary artery derived from atretic ductus

Cardiology in the Young ◽

10.1017/s1047951120000396 ◽

2020 ◽

Vol 30 (4) ◽

pp. 574-576

Author(s):

Andrew F. Schiff ◽

Derek A. Williams ◽

Yoshio Ootaki

Keyword(s):

Case Report ◽

Pulmonary Artery ◽

Balloon Dilatation ◽

Main Pulmonary Artery ◽

Innominate Artery ◽

Left Pulmonary Artery ◽

Branch Pulmonary Artery ◽

Alternative Diagnosis ◽

Absent Pulmonary Artery ◽

Absent Left Pulmonary Artery

AbstractTrue absence of a branch pulmonary artery is rare. We identified a patient initially diagnosed with an absent left pulmonary artery at a previous hospital. Due to disagreement in the initial diagnosis, she had a diagnostic catheterisation, which revealed an isolated left pulmonary artery off the left innominate artery via a ductus. The ductus was recanalised with serial stenting and balloon dilatation followed by reanastomosis to the main pulmonary artery. In a patient who initially is diagnosed with an absent pulmonary artery, an alternative diagnosis, such as this case report, should be considered.

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Anomalous origin of innominate artery from right pulmonary artery in DiGeorge syndrome

The Annals of Thoracic Surgery ◽

10.1016/s0003-4975(00)02585-6 ◽

2001 ◽

Vol 71 (6) ◽

pp. 2043-2044 ◽

Cited By ~ 5

Author(s):

Kagami Miyaji ◽

Robert L Hannan ◽

Redmond P Burke

Keyword(s):

Pulmonary Artery ◽

Digeorge Syndrome ◽

Innominate Artery ◽

Anomalous Origin ◽

Right Pulmonary Artery

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Main pulmonary artery to innominate artery shunt during hybrid palliation of hypoplastic left heart syndrome

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2005.06.010 ◽

2005 ◽

Vol 130 (4) ◽

pp. e1-e2 ◽

Cited By ~ 49

Author(s):

Christopher A. Caldarone ◽

Lee N. Benson ◽

Helen Holtby ◽

Glen S. Van Arsdell

Keyword(s):

Pulmonary Artery ◽

Hypoplastic Left Heart Syndrome ◽

Main Pulmonary Artery ◽

Innominate Artery ◽

Left Heart ◽

Hypoplastic Left Heart ◽

Left Heart Syndrome ◽

Hybrid Palliation

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A Rare Anatomic Variation: A Combination of Anomalous Origin of the Right Subclavian Artery from the Main Pulmonary Artery, Ventricular Septal Defect, and Aortic Coarctation

The Heart Surgery Forum ◽

10.1532/hsf98.20091172 ◽

2010 ◽

Vol 13 (3) ◽

pp. E202-E204 ◽

Cited By ~ 1

Author(s):

Can Vuran ◽

Oguz Omay ◽

Canan Ayabakan ◽

Ozgen Ilgaz Kocyigit ◽

Uygar Yoruker ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Pulmonary Artery ◽

Subclavian Artery ◽

Aortic Coarctation ◽

Septal Defect ◽

Anatomic Variation ◽

Main Pulmonary Artery ◽

Anomalous Origin ◽

The Right

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Management of a spontaneous supra-aortic arterial dissection: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02886-3 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Omar M. Sharaf ◽

Tomas D. Martin ◽

Eric I. Jeng

Keyword(s):

Innominate Artery ◽

Operative Management ◽

Computed Tomographic Angiography ◽

Artery Dissection ◽

Term Therapy ◽

Type I ◽

Computed Tomographic ◽

Tomographic Angiography ◽

Aortic Dissections ◽

Isolated Innominate Artery

Abstract Background Acute DeBakey type I and type II aortic dissections are indications for emergent surgical repair; however, there are currently no standard protocols in the management of isolated supra-aortic dissections. Prompt diagnosis and management of an isolated innominate artery dissection are necessary to prevent distal malperfusion and thromboembolic sequelae. Case presentation A 50-year-old Caucasian gentleman presented with chest pain radiating to his jaw and right arm. He had no recent history of trauma. On physical exam, he was neurologically intact and malignantly hypertensive. Computed tomographic angiography of the chest and neck confirmed a spontaneous isolated innominate artery dissection without ascending aorta involvement. Given the lack of evidence for rupture, distal emboli, and/or end-organ malperfusion, the decision was made for initial non-operative management—anti-impulse regimen, antiplatelet therapy, and close follow-up. Conclusions Medical management of a spontaneous isolated innominate artery dissection is appropriate for short-term and potentially long-term therapy. This not only spares the patient from a potentially unnecessary surgical operation but also provides the surgeon and the patient the time to plan for a surgical approach if it becomes necessary.

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A rare pediatric case of cluster headaches after cardiac catheterization in a patient with an isolated innominate artery

SAGE Open Medical Case Reports ◽

10.1177/2050313x211023679 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2110236

Author(s):

Kimberley Yu ◽

Madeline Chadehumbe

Keyword(s):

Aortic Arch ◽

Cardiac Catheterization ◽

Innominate Artery ◽

Dopamine Antagonists ◽

Autonomic Tone ◽

Pediatric Case ◽

Cluster Headaches ◽

Insight Into ◽

Secondary Causes ◽

Isolated Innominate Artery

While cluster headaches are classified and considered a primary headache disorder, secondary causes of cluster headaches have been reported and may provide insight into cluster headaches’ potential pathophysiology. The mechanisms underlying this headache phenotype are poorly understood, and several theories have been proposed that range from the activation within the posterior hypothalamus to autonomic tone dysfunction. We provide a review of reported cases in the literature describing secondary causes after cardiac procedures. We will present a novel pediatric case report of a 16-year-old boy with an isolated innominate artery who presented with acute new-onset headaches 8 h following cardiac catheterization of the aortic arch with arteriography and left pulmonary artery stent placement. The headaches were characterized by attacks of excruciating pain behind the left eye and jaw associated with ipsilateral photophobia, conjunctival injection, rhinorrhea, with severe agitation and restlessness. These met the International Classification of Headache Disorders-3 criteria for episodic cluster headaches. The headaches failed to respond to non-steroidal anti-inflammatory medications, dopamine antagonists, and steroids. He showed an immediate response to treatment with oxygen. This unique case of cluster headaches following cardiac catheterization in a pediatric patient with an isolated innominate artery may provide new insight into cluster headaches’ pathogenesis. We hypothesize that the cardiac catheterization induced cardiac autonomic changes that contributed to the development of his cluster headaches. The role of aortic arch anomalies and procedures in potential disruption of the autonomic tone and the causation of cluster headaches is an area requiring further study.

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Pulmonary atresia with a ventricular septal defect and left pulmonary artery discontinuity: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02750-4 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Hyun-Hwa Cha ◽

Hae Min Kim ◽

Won Joon Seong

Keyword(s):

Pulmonary Artery ◽

Subclavian Artery ◽

Septal Defect ◽

Left Subclavian Artery ◽

Ductus Arteriosus ◽

Main Pulmonary Artery ◽

Pulmonary Arteries ◽

Pulmonary Atresia ◽

Left Pulmonary Artery ◽

Right Pulmonary Artery

Abstract Background Unilateral pulmonary artery discontinuity is a rare malformation that is associated with other intracardiac abnormalities. Cases accompanied by other cardiac abnormalities are often missed on prenatal echocardiography. The prenatal diagnosis of isolated unilateral pulmonary artery discontinuity can also be delayed. However, undiagnosed this malformation would have an effect on further prognosis. We report our case of a prenatal diagnosis of pulmonary atresia with ventricular septal defect and left pulmonary artery discontinuity. Case presentation A 33-year-old Asian woman visited our institution at 24 weeks of gestation because of suspected fetal congenital heart disease. Fetal echocardiography revealed a small atretic main pulmonary artery giving rise to the right pulmonary artery without bifurcation and the left pulmonary artery arising from the ductus arteriosus originating from the left subclavian artery. The neonate was delivered by cesarean section at 376/7 weeks of gestation. Postnatal echocardiography and multidetector computed tomography showed a right aortic arch, with the small right pulmonary artery originating from the atretic main pulmonary artery and the left pulmonary artery originating from the left subclavian artery. Patency of the ductus arteriosus from the left subclavian artery was maintained with prostaglandin E1. Right ventricular outflow tract reconstruction and pulmonary angioplasty with Gore-Tex graft patch was performed 25th day after birth. Unfortunately, the neonate died because of right heart failure 8 days postoperation. Conclusion There is a possibility that both pulmonary arteries do not arise from the same great artery (main pulmonary artery or common arterial trunk). Therefore, clinicians should check the origin of both pulmonary arteries.

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