Aortic arch repair for complex coarctation of the aorta with aberrant bilateral subclavian artery

Abstract Background The purpose of this study was to explore echocardiographic views and methods of aortic arch anomalies in infants, so as to improve the screening sensitivity and diagnostic accuracy. Methods 140 children with abnormal aortic arch diagnosed by ultrasound in Children’s Hospital of Hebei Province from January 2014 to December 2019 were selected for retrospective analysis. All were confirmed by surgery or/and computerized tomography angiography. Series of views for aortic arch (the three-vessel and tracheal view, aortic arch short axis view, left aortic arch long axis view, aortic arch long axis continuous scan views) were performed in all cases on the basis of the routine views of echocardiography. The screening sensitivity and diagnostic coincidence rate of different echocardiographic views for aortic arch anomalies were analyzed. Results Among the 140 infants, right aortic arch were 21 cases (6/21 were accompanied by mirror branch and 15/21 were with aberrant left subclavian artery). Left aortic arch with aberrant right subclavian artery were 2 cases, and double aortic arch with both arches open were 20 cases. Double aortic arch with left arch atresia were 2 cases, and atresia of the proximal aorta with aortic arch dysplasia was 1 case. Coarctation of the aorta were 67 cases, and interruption of aortic arch were 27 cases. All the patients were correctly diagnosed except that 2 infants with interruption of aortic arch were incorrectly diagnosed as coarctation of the aorta, and 1 infant with coarctation of the aorta was misdiagnosed as interruption of aortic arch by echocardiography. The screening sensitivities of four views and four-view combination for abnormal aortic arch were 99.3, 73.6, 87.1, 99.3, and 100%; the diagnostic coincidence rates were 85.7, 27.1,66.4, 95.0%, and 97.9% respectively. On the basis of traditional left aortic long axis view, other three views had their own advantages. The screening sensitivity and diagnostic coincidence rate of four-view combination were significantly improved. Conclusions The three-vessel trachea view is simple and feasible, which is suitable for screening abnormal aortic arch. The combination of four views conduces to improving screening sensitivity and diagnostic accuracy of aortic arch abnormalities.

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P2244Anomalies in women of the aortic arch in Turner syndrome as an important risk factor for premature morbidity and mortality

European Heart Journal ◽

10.1093/eurheartj/ehz748.0722 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

E Klaskova ◽

S Kapralova ◽

J Zapletalova ◽

Z Tudos ◽

K Adamova

Keyword(s):

Risk Factor ◽

Aortic Arch ◽

Cell Line ◽

Turner Syndrome ◽

Subclavian Artery ◽

X Chromosome ◽

Coarctation Of The Aorta ◽

Aberrant Right Subclavian Artery ◽

Structural Abnormality ◽

Study Group

Abstract Introduction Turner syndrome (TS) represents the most common chromosomal disorder in women being, caused by the absence or structural abnormality of X chromosome. Congenital heart defects affect up to 50% of females with TS.Prevalence of coarctation of the aorta in TS has been estimated 7–18% depending on imaging method. Introduction of cardiac magnetic resonance imaging (MRI) into the routine practice markedly increased the detection rate of anomalies of the aortic arch such as elongated transverse aortic arch with abnormal curvature, i.e.kinking, pseudocoarctation or aberrant right subclavian artery. Aims of study was to estimate prevalence of anomalies of the aortic arch in our study group according to the karyotype. Methods and patients Study group consisted of 67 patients with TS at the age 7.3 yrs (range 0.1 - 16.5 yrs.). Complete cardiovascular examination (echocardiography, MRI of the heart and great vessels) and cytogenetic examination were performed in each of our study patient. Results The prevalence of anomalies of the aortic arch was 15% (10 patients). Four of them had elongated transverse aortic, coarctation of the aorta was found in three cases, aberrant right subclavian artery in two patients and one girl had right aortic arch. 45,X cell line was presented in every patient with anomaly of the aortic arch, none of them had structural abnormality of X chromosome. Conclusions Compared with the general population, the prevalence of CoA and the others anomalies of the aortic arch is significantly higher in women with TS, especially with 45,X cell line. As far as CoA is considered to be one of the major risk factor for aortic dissection detailed cardiovascular screening focused on thoracic aorta anomalies seems to be crucial in order to prevent it. Acknowledgement/Funding Supported by Ministry of Health, Czech Republic - MZ VES 2017 (Reg. No. NV17-29111A).

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Left cervical aortic arch associated with multiple vascular anomalies

Cardiology in the Young ◽

10.1017/s1047951111000515 ◽

2011 ◽

Vol 21 (6) ◽

pp. 700-702

Author(s):

José Luiz Balthazar Jacob

Keyword(s):

Aortic Arch ◽

Subclavian Artery ◽

Left Subclavian Artery ◽

Coarctation Of The Aorta ◽

Vascular Anomalies ◽

Single Patient ◽

Cardiovascular Abnormalities ◽

Rare Anomaly ◽

Transverse Arch ◽

Brachiocephalic Arteries

AbstractCervical aortic arch is a rare anomaly occasionally associated with other cardiovascular abnormalities. We present a case of tortuous left cervical aortic arch associated with hypoplastic transverse arch, coarctation of the aorta, and right brachiocephalic arteries arising below the coarctation and stenotic origin of the left subclavian artery. These multiple anatomic anomalies, which are associated in our case, have not been described in a single patient previously.

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Aortic arch augmentation using a pulmonary artery autograft patch and a reversed left subclavian artery flap for an interrupted aortic arch type B complex

Cardiology in the Young ◽

10.1017/s1047951113000899 ◽

2013 ◽

Vol 24 (3) ◽

pp. 559-562 ◽

Cited By ~ 6

Author(s):

Tomomi Hasegawa ◽

Yoshihiro Oshima ◽

Tasuku Kadowaki

Keyword(s):

Pulmonary Artery ◽

Aortic Arch ◽

Subclavian Artery ◽

Left Subclavian Artery ◽

Interrupted Aortic Arch ◽

Type B ◽

Aortic Arch Reconstruction ◽

Aortic Arch Repair ◽

Arch Reconstruction ◽

Bronchial Compression

AbstractAdequate arch augmentation for interrupted aortic arch repair is quite important to avoid post-operative recoarctation and bronchial compression. We describe here two successful cases of aortic arch reconstruction using autologous materials such as a pulmonary artery patch and a reversed left subclavian artery flap in infants with an interrupted aortic arch type B complex.

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Creating an Arc-Shaped Aorta: Use of the Subclavian Artery for Interrupted Aortic Arch Repair

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2014.09.053 ◽

2015 ◽

Vol 99 (2) ◽

pp. 648-652 ◽

Cited By ~ 3

Author(s):

Melchior Burri ◽

Jelena Kasnar-Samprec ◽

Julie Cleuziou ◽

Christian Nöbauer ◽

Manfred O. Vogt ◽

...

Keyword(s):

Aortic Arch ◽

Subclavian Artery ◽

Interrupted Aortic Arch ◽

Aortic Arch Repair

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Perioperative evaluation of neonatal aortic arch thrombosis

10.22541/au.162505777.79215214/v1 ◽

2021 ◽

Author(s):

fumiya yoneyama ◽

Travis Wilder ◽

Michiaki Imamura

Keyword(s):

Computed Tomography ◽

Aortic Arch ◽

Critical Condition ◽

Preoperative Evaluation ◽

Coarctation Of The Aorta ◽

Postoperative Evaluation ◽

Aortic Arch Repair ◽

Thrombus Removal

Herein, we present a neonatal case of coarctation of the aorta, with aortic arch thrombus confirmed by echocardiography. We performed thrombus removal and aortic arch repair emergently. This critical condition necessitates quick preoperative evaluation with echocardiography. Moreover, postoperative evaluation using computed tomography is reasonable to assess an aortic arch configuration, and exclude the remnant thrombus.

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Hybrid repair of an adult with a double aortic arch, coarctation of the aorta, and left subclavian artery aneurysm

Journal of Vascular Surgery Cases and Innovative Techniques ◽

10.1016/j.jvscit.2019.06.006 ◽

2019 ◽

Vol 5 (4) ◽

pp. 535-537

Author(s):

Kameron T. Bell ◽

Maranda R. McKinney ◽

Paul A. Salazar ◽

Eduardo Esper

Keyword(s):

Aortic Arch ◽

Subclavian Artery ◽

Left Subclavian Artery ◽

Artery Aneurysm ◽

Coarctation Of The Aorta ◽

Double Aortic Arch ◽

Subclavian Artery Aneurysm ◽

Hybrid Repair

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Right retroesophageal subclavian artery

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502003001200020 ◽

2003 ◽

Vol 18 (suppl 5) ◽

pp. 54-56 ◽

Cited By ~ 8

Author(s):

Valéria Paula Sassoli Fazan ◽

Rogério Alves Ribeiro ◽

João Alberto S. Ribeiro ◽

Omar Andrade Rodrigues Filho

Keyword(s):

Aortic Arch ◽

Subclavian Artery ◽

Anatomical Variations ◽

Inflammatory Lesions ◽

Intensive Care Patients ◽

Fatal Hemorrhage ◽

Retroesophageal Subclavian Artery ◽

Aortic Arch Repair ◽

The Right

PURPOSE: The subclavian arteries can vary on their origin, course or length. One of the most common anatomical variations is the right subclavian artery originating as the last branch of the aortic arch. This artery is known as a retroesophageal right subclavian artery or "lusory artery". The right retroesophageal subclavian artery usually is described as not producing symptoms, being most discoveries coincidental. Nevertheless, it may be the site of formation of atherosclerotic plaque, inflammatory lesions or aneurysm. CASE REPORT: The present study describes a case of right retroesophageal subclavian artery and discusses the findings according to their clinical and surgical implications. CONCLUSION: The anatomic and morphologic variations of the aortic arch and its branches are significant for diagnostic and surgical procedures in the thorax and neck. If a right retroesophageal subclavian artery is diagnosed during aortic arch repair, corrective surgery should be considered. Intensive care patients should be screened before long term placement of nasogastic tube, in order to avoid fistulization and fatal hemorrhage.

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Left-sided abnormalities

10.1093/med/9780198766520.003.0010 ◽

2018 ◽

Author(s):

Nick Archer ◽

Nicky Manning

Keyword(s):

Aortic Stenosis ◽

Aortic Arch ◽

Subclavian Artery ◽

Coarctation Of The Aorta ◽

Venous Drainage ◽

Interrupted Aortic Arch ◽

Right Aortic Arch ◽

Vascular Rings ◽

Mitral Atresia ◽

Anomalous Pulmonary Venous Drainage

This chapter explores left-sided abnormalities, discussing venoatrial abnormalities (including partial anomalous pulmonary venous drainage, total anomalous pulmonary venous drainage, and left-sided SVC), atrioventricular abnormalities (mitral atresia and mitral hypoplasia), ventriculoarterial abnormalities (including aortic stenosis, aortic atresia, and hypoplastic le. heart syndrome), and arterial abnormalities (coarctation of the aorta, interrupted aortic arch, right aortic arch, aberrant subclavian artery, double aortic arch, persistent fifth aortic arch, vascular rings, and aorto-pulmonary window).

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