Challenges in the management of coarctation of the aorta

2020 ◽  
pp. 145-162
Author(s):  
Salim Jivanji ◽  
Robin HS Chen ◽  
Eric Rosenthal
Keyword(s):  
Cardiac Catheterization ◽  
Subclavian Artery ◽  
Successful Treatment ◽  
Conservative Management ◽  
Somatic Growth ◽  
Coarctation Of The Aorta ◽  
Aberrant Right Subclavian Artery ◽  
The Common

A postnatally diagnosed child underwent stenting of his native coarctation of the aorta after initial conservative management. After successful treatment of his coarctation, he was followed up regularly and was noted to develop hypertension. Subsequent investigations confirmed that he required further dilatation of his stent in view of somatic growth. Cardiac catheterization revealed an aneurysm at the site of the previous stenting. Given his aberrant right subclavian artery (ARSCA), the procedure was terminated with a view to the best method of treatment. He subsequently underwent re-stenting of his coarctation, with protection of his ARSCA with a balloon over a wire. The chapter explores the challenges in managing this condition using angioplasty, stenting, or surgery, and the common pitfalls that are encountered in the life of patients with this condition.

scholarly journals Study on the views and methods of ultrasonic screening and diagnosis for abnormal aortic arch in infants

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xinjian He ◽  
Jiaoyang Chen ◽  
Gaoyang Li
Keyword(s):  
Diagnostic Accuracy ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Coarctation Of The Aorta ◽  
Double Aortic Arch ◽  
Aberrant Right Subclavian Artery ◽  
Coincidence Rate ◽  
Aortic Arch Anomalies ◽  
Screening Sensitivity ◽  
Axis View

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.

scholarly journals Surgical correction of coarctation of the aorta featuring an incomplete circle of Willis

2020 ◽  
Vol 30 (5) ◽  
pp. 794-795
Author(s):  
Aiko Sonobe ◽  
Hideyuki Kato ◽  
Bryan J Mathis ◽  
Yuji Hiramatsu
Keyword(s):  
Subclavian Artery ◽  
Coarctation Of The Aorta ◽  
Circle Of Willis ◽  
Surgical Correction ◽  
Surgical Strategy ◽  
Aberrant Right Subclavian Artery ◽  
Coarctation Of Aorta ◽  
Rare Anomaly ◽  
Cerebral Malperfusion

Abstract Although devastating complications during simple coarctation of aorta repair now occur less frequently, some unique cases still require extra caution. Here, we report a case of coarctation of the aorta with a rare anomaly in the circle of Willis and an aberrant right subclavian artery, which required a thorough surgical strategy that prevented cerebral malperfusion.

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

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).

Aberrant right subclavian artery with preductal coarctation of the aorta

2003 ◽  
Vol 76 (3) ◽  
pp. 927-929 ◽  
Author(s):  
Yoshihiro Ko ◽  
Yuzuru Nakamura ◽  
Michio Yoshitake ◽  
Takahiro Inoue
Keyword(s):  
Subclavian Artery ◽  
Coarctation Of The Aorta ◽  
Aberrant Right Subclavian Artery

Be Aware of Aberrant Right Subclavian Artery Origin Before Aortic Coarctation Stenting: A Case Report Study

2019 ◽  
Vol 53 (7) ◽  
pp. 609-612
Author(s):  
Alireza Dehghan ◽  
Sara Haseli ◽  
Pedram Keshavarz ◽  
Marzieh Ahmadi ◽  
Pooyan Dehghani
Keyword(s):  
Subclavian Artery ◽  
Coarctation Of The Aorta ◽  
Vascular Anomaly ◽  
Subclavian Steal Syndrome ◽  
Aberrant Right Subclavian Artery ◽  
Descending Aorta ◽  
Subclavian Steal ◽  
Aortic Stenting ◽  
Artery Flow ◽  
Steal Syndrome

The subclavian steal syndrome (SSS), also called subclavian steal steno-occlusive disease, is defined as reversal of the vertebral artery flow secondary to significant hemodynamically ipsilateral occlusion or stenosis of the proximal subclavian artery. It is usually seen secondary to atherosclerosis and aberrant right subclavian artery (ARSA), resulting in SSS which is even less common. Aberrant right subclavian artery is a kind of vascular anomaly associated with coarctation of the aorta (CoA). It usually originates from the descending aorta distal to the site of CoA. Here, we present a young man who was a case of ARSA and CoA. He developed SSS after transcatheter aortic stenting secondary to unusual origin of ARSA from the site of CoA. Awareness of this rare anomaly helps to overcome this complication in patients undergoing interventional stenting for CoA and ARSA with anomalous origin.

scholarly journals Dysphagia Lusoria: A Case of an Aberrant Right Subclavian Artery and a Bicarotid Trunk

ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
A. D. Rogers ◽  
M. Nel ◽  
E. P. Eloff ◽  
N. G. Naidoo
Keyword(s):  
Weight Loss ◽  
Carotid Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Aberrant Right Subclavian Artery ◽  
Aortic Arch Anomalies ◽  
Dysphagia Lusoria ◽  
Marked Weight ◽  
The Common ◽  
The Right

Dysphagia Lusoria is dysphagia secondary to an aberrant right subclavian artery that has a retroesophageal course. Adachi and Williams categorized aortic arch anomalies, showing that the right subclavian artery arising in this fashion (as the final branch of the descending aortic arch) is one of the more common. However, this very rarely coexists with a bicarotid trunk. We present such a case as it is manifested in a 36-year-old lady complaining of marked weight loss and dysphagia. The diagnosis remained elusive until a CT scan of the chest was performed; angiography further delineated the pathology. It is believed that the combination of the common carotid origins with the retroesophageal course of the aberrant vessel more frequently accounts for symptoms in the absence of an aneurysm of the origin of the aberrant vessel. Several techniques to manage the aberrant vessel have been described in the literature, but we favoured open ligation and transposition to the right carotid artery.

scholarly journals Airway implications of post-ductal coarctation of the aorta and an aberrant right subclavian artery

2008 ◽  
Vol 55 (9) ◽  
pp. 651-652
Author(s):  
Satyajeet Misra ◽  
Prasanta Kumar Dash ◽  
Thomas Koshy ◽  
Sethuraman Manikandan ◽  
Madathipat Unnikrishnan ◽  
...  
Keyword(s):  
Subclavian Artery ◽  
Coarctation Of The Aorta ◽  
Aberrant Right Subclavian Artery

Republished: Multiple anomalies in the origin and course of vertebral arteries and aberrant right subclavian artery in a child with moyamoya syndrome

2018 ◽  
Vol 10 (6) ◽  
pp. e14-e14
Author(s):  
Pınar Beyaz ◽  
Nadia Khan ◽  
Gerasimos Baltsavias
Keyword(s):  
Case Report ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Anomalous Origin ◽  
Aberrant Right Subclavian Artery ◽  
Moyamoya Syndrome ◽  
Vertebral Arteries ◽  
The Common ◽  
The Right ◽  
First Time

Here we report, for the first time, a combination of five-vessel aortic arch, anomalous origin of the right vertebral artery (VA) from the common carotid artery (CCA), an aberrant right subclavian artery (SCA), and bilateral symmetrical segmental agenesis of VAs.In this case report, we present a patient with moyamoya syndrome (MMS) and Down syndrome (DS) who has bilateral symmetrical segmental agenesis of VAs, left VA originating from aortic arch and anomalous origin of right VA arising from CCA in combination with an aberrant right SCA. Therefore, five vessels are originating from aortic arch. Here, we report, for the first time, a combination of five-vessel aortic arch with an aberrant right SCA and symmetrical segmental agenesis of both VAs. The possible embryological mechanisms of the anomalies as well as an relation with MMS and DS are discussed.

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