Isolated left subclavian with a compensatory ductus in a child with Tetralogy of Fallot

2021 ◽  
pp. 021849232199738
Author(s):  
Subramanian Chellappan ◽  
Krishna Manohar ◽  
Yogesh Sathe ◽  
Siddharth Amboli ◽  
Radha Joshi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Tetralogy Of Fallot ◽  
Subclavian Artery ◽  
Pulmonary Blood Flow ◽  
De Novo ◽  
Left Subclavian Artery ◽  
Cyanotic Heart Disease ◽  
Intracardiac Repair ◽  
Aortopulmonary Collaterals ◽  
Arterial Insufficiency

Tetralogy of Fallot is a cyanotic heart disease wherein aortopulmonary collaterals serve as source of pulmonary blood flow to maintain oxygenation. We report an incidentally detected isolated left subclavian artery supplying a compensatory ductus in a child with Tetralogy of Fallot that effectively contributed as a de novo palliative systemic to pulmonary artery shunt. Clinically, the entity could not be suspected, as the child did not have symptoms suggestive of arterial insufficiency of the left arm or weak pulses or neurological symptoms. The child underwent successful intracardiac repair with a reimplantation of left subclavian artery to left common carotid artery.

Influence of pulmonary blood flow on management and outcome

2011 ◽  
Keyword(s):  
Blood Flow ◽  
Heart Disease ◽  
Pulmonary Circulation ◽  
Early Life ◽  
Pulmonary Blood Flow ◽  
Venous Blood ◽  
Cyanotic Heart Disease ◽  
Capillary Membrane ◽  
Pulmonary Vascular Development ◽  
Alveolar Capillary

Introduction 50Pulmonary vascular development in early life 50Cyanotic heart disease and pulmonary blood flow 52Delivery of systemic venous blood to the alveolar capillary membrane to allow release of waste CO2 and uptake of O2 depends on the integrity of the pulmonary circulation. Too little blood flow to the lungs and the patient is hypoxic; too much and the lungs become oedematous....

scholarly journals Is there any need for a shunt in the treatment of tetralogy of Fallot with one source of pulmonary blood flow?†

2013 ◽  
Vol 44 (4) ◽  
pp. 648-654 ◽  
Author(s):  
Claudia Arenz ◽  
Alke Laumeier ◽  
Stefanie Lütter ◽  
Hedwig Christine Blaschczok ◽  
Nicodème Sinzobahamvya ◽  
...  
Keyword(s):  
Blood Flow ◽  
Tetralogy Of Fallot ◽  
Pulmonary Blood Flow

Axilloaxillary Bypass for the Treatment of Subclavian Artery Stenosis Complicated by Bilateral Common Carotid Artery Occlusion: Technical Case Report

Neurosurgery ◽  
2003 ◽  
Vol 53 (2) ◽  
pp. 444-447 ◽  
Author(s):  
Masahiro Ogino ◽  
Masashi Nagumo ◽  
Toru Nakagawa ◽  
Masashi Nakatsukasa ◽  
Ikuro Murase
Keyword(s):  
Blood Flow ◽  
Carotid Artery ◽  
Vertebral Artery ◽  
Subclavian Artery ◽  
Bypass Surgery ◽  
Left Subclavian Artery ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Bilateral Common Carotid Artery ◽  
Common Carotid Artery Occlusion

Abstract OBJECTIVE AND IMPORTANCE We successfully treated a patient with stenosis of the left subclavian artery, complicated by bilateral common carotid artery occlusion, via axilloaxillary bypass surgery. CLINICAL PRESENTATION A 67-year-old patient with a history of hypertension and cerebral infarction underwent neck irradiation for treatment of a vocal cord tumor. Three months later, he began to experience transient tetraparesis several times per day. The blood pressure measurements for his right and left arms were different. Supratentorial blood flow was markedly low. The common carotid arteries were bilaterally occluded, and the right vertebral artery was hypoplastic. Therefore, only the left vertebral artery contributed to the patient's cerebral circulation; his left subclavian artery was severely stenotic. INTERVENTION The patient underwent axilloaxillary bypass surgery because the procedure avoids thoracotomy or sternotomy, manipulation of the carotid artery, and interruption of the vertebral artery blood flow. The patient has been free of symptoms for more than 5 years. CONCLUSION Neurosurgeons should be aware that extra-anatomic bypass surgery is an effective treatment option for selected patients with cerebral ischemia.

Aberrant left subclavian artery in tetralogy of Fallot

1980 ◽  
Vol 45 (4) ◽  
pp. 811-818 ◽  
Author(s):  
Guillermo Velasquez ◽  
Pisupati H. Nath ◽  
Wilfrido R. Castaneda-Zuniga ◽  
Kurt Amplatz ◽  
Augustin Formanek
Keyword(s):  
Tetralogy Of Fallot ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Aberrant Left Subclavian Artery

scholarly journals Phenylephrine increases pulmonary blood flow in children with tetralogy of Fallot

2003 ◽  
Vol 50 (9) ◽  
pp. 926-929 ◽  
Author(s):  
Katsuya Tanaka ◽  
Hiroshi Kitahata ◽  
Shinji Kawahito ◽  
Junpei Nozaki ◽  
Yoshinobu Tomiyama ◽  
...  
Keyword(s):  
Blood Flow ◽  
Tetralogy Of Fallot ◽  
Pulmonary Blood Flow

Influence of pulmonary blood flow on management and outcome

2017 ◽  
Author(s):  
Sara Thorne ◽  
Sarah Bowater
Keyword(s):  
Blood Flow ◽  
Heart Disease ◽  
Early Life ◽  
Pulmonary Blood Flow ◽  
Vascular Development ◽  
Cyanotic Heart Disease ◽  
Pulmonary Vascular Development

This chapter discusses the influence of pulmonary blood flow on management and outcome, including pulmonary vascular development in early life, cyanotic heart disease, and pulmonary blood flow.

Tetralogy of Fallot, right aortic arch with isolated left subclavian artery: Rare synchronous triple occurrence!!!

2020 ◽  
Vol 35 (10) ◽  
pp. 2804-2805
Author(s):  
Rishabh Khurana ◽  
Arun Sharma ◽  
Sheragaru Hanumanthappa Chandrashekhara ◽  
Amit Ajit Deshpande
Keyword(s):  
Aortic Arch ◽  
Tetralogy Of Fallot ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Right Aortic Arch

Abstract 4567: Functional Intraoperative Pulmonary Blood Flow Study is a Sensitive Predictor of Right Ventricular Pressure and Successful VSD Closure for Following Complete Uniforcalization in Patients with Pulmonary Atresia with Ventricular Septal Defect and Major Aortopulmonary Collaterals

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Osami Honjo ◽  
Osman O Al-Radi ◽  
Cathy MacDonald ◽  
Lisa Davey ◽  
Christopher A Caldarone ◽  
...  
Keyword(s):  
Blood Flow ◽  
Ventricular Septal Defect ◽  
Pulmonary Blood Flow ◽  
Septal Defect ◽  
Pulmonary Atresia ◽  
Systolic Pressure ◽  
Pulmonary Flow ◽  
Aortopulmonary Collaterals ◽  
Major Aortopulmonary Collaterals ◽  
Flow Study

OBJECTIVE: We hypothesized mean pulmonary artery (PA) pressure obtained from an intraoperative pulmonary flow study would better predict the ability to close the ventricular septal defect (VSD) and better predict postoperative right ventricular systolic pressure (RSVP) than classic anatomical parameters after complete uniforcalization in patients with pulmonary atresia, VSD, and major aortopulmonary collaterals. METHODS: Sixteen consecutive patients (median, 11 mo, range 2 mo – 16 yrs) underwent one-stage (75%) or staged (25%) uniforcalization between 1/03 and 8/07. Intraoperative functional pulmonary blood flow study was achieved by inserting an arterial cannula in a reconstructed central PA. Flow was increased to 2.5 L/min/m2 while measuring PA pressure. RVSP and systemic systolic pressure (SBP) were recorded after VSD closure. Total neopulmonary artery index (TNPAI) (MAPCA + native PA index), total incorporated pulmonary vascular segments, and pulmonary segment artery ratio (PSAR) (ratio of incorporated segment to 18) were analyzed. Spearman rank correlation and area under the receiver operator characteristics curve (ROC-AUC) were used. RESULTS: The mean PA pressure on flow study was 21.8+/−6.2 mmHg (range, 11–31). Three patients had a pressure of > 30 mmHg. The VSD was closed in 14 (87%). One patient with flow study mean PA pressure of 25 mmHg had suprasystemic RVSP and underwent intraoperative VSD fenestration. One with a flow study mean PA pressure of 30 mmHg had a prospective fenestrated VSD patch placed. There is a weak negative correlation between TNPAI and the flow study PA pressure (rho=−0.4, p=0.12). The flow study mean PA pressure was correlated with post-repair RVSP (rho=0.72, p=0.0027), and with RVSP/SBP ratio (rho=0.67, p=0.0063). TNPAI, total incorporated segments, and PSAR were not correlated with the postoperative RVSP or RVSP/SBP ratio. Flow study mean PA pressure had the highest sensitivity in predicting VSD closure: ROC-AUC (0.82) vs. TNPAI (0.46), pulmonary segment (0.64), and PSAR (0.64). CONCLUSIONS: Intraoperative pulmonary flow study predicted the ability of VSD closure better than total incorporated segments, TNPAI, and PSAR. Flow study mean PA pressure highly correlated with postoperative RVSP and RVSP/SBP ratio.

Reverse Subclavian Flap Repair and Maintenance of Antegrade Blood Flow within the Left Subclavian Artery in Neonates with Aortic Coarctation and Distal Arch Hypoplasia

2013 ◽  
Vol 16 (1) ◽  
pp. 52 ◽  
Author(s):  
Yuri S. Sinelnikov ◽  
A. V. Gorbatyh ◽  
S. M. Ivantsov ◽  
M. S. Strelnikova ◽  
I. A. Kornilov ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Aortic Coarctation ◽  
Left Subclavian Artery ◽  
Surgical Palliation ◽  
Flap Repair ◽  
Neonates And Infants ◽  
Aortic Arch Hypoplasia

Surgical palliation for aortic coarctation with aortic arch hypoplasia in neonates and infants has been used in the clinic as the most beneficial treatment for this disorder. This technique allows the correction of aortic coarctation by the use of "extended" anastomosis without cardiopulmonary bypass, which expands the hypoplastic distal aortic arch via the use of a reverse subclavian flap repair. This technique maintains antegrade blood flow within the left subclavian artery.

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