Complex Transposition of the Great Arteries with Interrupted Aortic Arch: Modified Great Vessel Reconstruction

1996 ◽  
Vol 4 (1) ◽  
pp. 26-28
Author(s):  
Jacques AM van Son
Keyword(s):  
Aortic Arch ◽  
Main Pulmonary Artery ◽  
Coarctation Of The Aorta ◽  
Radical Resection ◽  
Interrupted Aortic Arch ◽  
Ascending Aorta ◽  
Growth Potential ◽  
Great Vessel ◽  
Long Distance ◽  
Descending Aorta

Transposition of the great arteries with ventricular septal defect is often associated with anterior malalignment of the conal septum, hypoplasia of the ascending aorta and aortic arch, interrupted aortic arch or coarctation of the aorta, and hyperplasia of the main pulmonary artery. This marked disparity in great vessel size can result in difficulties at and beyond the neo-aorta-to-ascending aorta suture line, such as bleeding, distortion, obstruction, or the use of nonviable patch material. A modified surgical approach is presented in which the ascending aorta is anastomosed to the descending aorta, followed by anastomosis of the neo-aorta to the underside of the newly constructed aortic arch using a native aortic flap. The proposed technique greatly simplifies the reconstruction of the neo-aorta and the interrupted aortic arch, reduces tension on the neo-aorta to neo-aortic arch anastomosis, and preserves growth potential of the latter. This modification can especially be of benefit after radical resection of ductal tissue, particularly in association with interrupted aortic arch type A, with resulting long distance between the ascending and descending aorta.

Transcatheter mechanical thrombectomy of neonatal occlusive aortic thrombus using an Amplatzer Piccolo PDA occluder

2021 ◽  
pp. 1-3
Author(s):  
Christopher Herron ◽  
Stuart Covi ◽  
Athina Pappas ◽  
Daisuke Kobayashi
Keyword(s):  
Aortic Arch ◽  
Critical Condition ◽  
Mechanical Thrombectomy ◽  
Coarctation Of The Aorta ◽  
Premature Neonate ◽  
Interrupted Aortic Arch ◽  
Thromboembolic Events ◽  
Descending Aorta ◽  
Aortic Thrombus

Abstract Neonatal aortic thrombus is a rare and critical condition that can present mimicking severe coarctation of the aorta or interrupted aortic arch. Transcatheter thrombectomy for this lesion has not been well described. We report a premature neonate with an occlusive proximal descending aorta thrombus, who underwent transcatheter mechanical thrombectomy using an Amplatzer Piccolo PDA occluder (Abbott, North Chicago, IL, USA). The procedure was successful with no subsequent distal thromboembolic events.

Off-pump ascending aorta or aortic arch to descending aorta bypass with a pericardial roll for the treatment of critically ill infants with interrupted aortic arch

2020 ◽  
Vol 30 (8) ◽  
pp. 1095-1102
Author(s):  
Didem M. Oztas ◽  
Mert Meric ◽  
Metin O. Beyaz ◽  
Senay Coban ◽  
Gizem Sari ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Critically Ill ◽  
Septal Defect ◽  
Single Ventricle ◽  
Interrupted Aortic Arch ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Off Pump ◽  
Aorta Bypass

AbstractAim:Standard surgical treatment of the interrupted aortic arch with the use of cardiopulmonary bypass is risky especially in critically ill babies. In this manuscript, we present the results of off-pump pericardial roll bypass for the treatment of aortic interruption.Material and methods:The technique was applied in nine critically ill infants between July 2011 and December 2019. Data were reviewed retrospectively. There were four girls and five boys. The types of the interruption were type B in six cases and type A in three babies. Additional cardiovascular anomalies were ventricular septal defect in all, atrial septal defect or patent foramen ovale in all, single-ventricle pathologies in two and bicuspid aortic valve in three cases. All the patients were in critical situations such as intubated, having symptoms of infection, congestive heart failure or ischaemia and malperfusion leading visceral organ dysfunction.Results:All patients underwent off-pump ascending aorta or aortic arch to descending aorta bypass with a pericardial roll. Post-operative early mortality occurred in one patient with severe mitral regurgitation due to cardio-septic shock. One patient who had single-ventricle pathology underwent bidirectional Glenn and was lost on the post-operative 26th day due to sepsis 2 years after operation. Two patients presented with dilatation of the pericardial tube 18 and 24 months after the operations and one underwent reconstruction of the neo-arch. The remaining patients are asymptomatic, active and within normal limits of body and mental growth.Conclusion:Treatment of interrupted aortic arch with a bypass with an autologous pericardial roll treated with gluteraldehyde without cardiopulmonary bypass seems a safe and reliable technique especially for the treatment of critically ill infants.

Aortic atresia and interrupted aortic arch communicating through external carotid anastomosis

2019 ◽  
Vol 29 (5) ◽  
pp. 699-700
Author(s):  
Volodia Dangouloff-Ros ◽  
Nathalie Boddaert ◽  
Francesca Raimondi
Keyword(s):  
Aortic Arch ◽  
Interrupted Aortic Arch ◽  
Ascending Aorta ◽  
External Carotid ◽  
Retrograde Flow ◽  
Descending Aorta ◽  
Vertebral Arteries ◽  
Aortic Atresia ◽  
Newborn Girl

AbstractWe describe the case of a newborn girl who displayed association of aortic atresia and interrupted aortic arch, with retrograde flow in ascending aorta, through extracranial anastomoses between vertebral arteries (arisen from descending aorta) and external carotids.

Dilatation of the entire thoracic aorta in patients with bicuspid aortic valve: a magnetic resonance angiography study

VASA ◽  
2005 ◽  
Vol 34 (3) ◽  
pp. 181-185 ◽  
Author(s):  
Westhoff-Bleck ◽  
Meyer ◽  
Lotz ◽  
Tutarel ◽  
Weiss ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Aortic Valve ◽  
Pulmonary Artery ◽  
Aortic Arch ◽  
Thoracic Aorta ◽  
Aortic Root ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Severe Aortic Regurgitation

Background: The presence of a bicuspid aortic valve (BAV) might be associated with a progressive dilatation of the aortic root and ascending aorta. However, involvement of the aortic arch and descending aorta has not yet been elucidated. Patients and methods: Magnetic resonance angiography (MRA) was used to assess the diameter of the ascending aorta, aortic arch, and descending aorta in 28 patients with bicuspid aortic valves (mean age 30 ± 9 years). Results: Patients with BAV, but without significant aortic stenosis or regurgitation (n = 10, mean age 27 ± 8 years, n.s. versus control) were compared with controls (n = 13, mean age 33 ± 10 years). In the BAV-patients, aortic root diameter was 35.1 ± 4.9 mm versus 28.9 ± 4.8 mm in the control group (p < 0.01). The diameter of the ascending aorta was also significantly increased at the level of the pulmonary artery (35.5 ± 5.6 mm versus 27.0 ± 4.8 mm, p < 0.001). BAV-patients with moderate or severe aortic regurgitation (n = 18, mean age 32 ± 9 years, n.s. versus control) had a significant dilatation of the aortic root, ascending aorta at the level of the pulmonary artery (41.7 ± 4.8 mm versus 27.0 ± 4.8 mm in control patients, p < 0.001) and, furthermore, significantly increased diameters of the aortic arch (27.1 ± 5.6 mm versus 21.5 ± 1.8 mm, p < 0.01) and descending aorta (21.8 ± 5.6 mm versus 17.0 ± 5.6 mm, p < 0.01). Conclusions: The whole thoracic aorta is abnormally dilated in patients with BAV, particularly in patients with moderate/severe aortic regurgitation. The maximum dilatation occurs in the ascending aorta at the level of the pulmonary artery. Thus, we suggest evaluation of the entire thoracic aorta in patients with BAV.

Aneurysm Hybrid Treatment by Simultaneous Replacement of Ascending Aorta and Aortic Arch and Endoluminal Stenting of the Descending Aorta

2006 ◽  
Vol 9 (1) ◽  
pp. E530-E532
Author(s):  
Friedrich-Christian Riess ◽  
Hans Krankenberg ◽  
Thilo Tübler ◽  
Matthias Danne
Keyword(s):  
Aortic Arch ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Hybrid Treatment

Type B Interrupted Aorta in an Adult Patient

2014 ◽  
Vol 17 (2) ◽  
pp. 80
Author(s):  
Ahmet Ozkara ◽  
Mehmet Ezelsoy ◽  
Levent Onat ◽  
Ilhan Sanisoglu
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Collateral Circulation ◽  
Neonatal Period ◽  
Interrupted Aortic Arch ◽  
Complete Loss ◽  
Posterolateral Thoracotomy ◽  
Type B ◽  
Case Presentation ◽  
Descending Aorta

<p><b>Introduction:</b> Interrupted aortic arch is a rare congenital malformation characterized by a complete loss of luminal continuity between the ascending and descending aorta. It is often diagnosed during the neonatal period.</p><p><b>Case presentation:</b> We presented a 51-year-old male patient with interrupted aortic arch type B who was treated successfully with posterolateral thoracotomy without using cardiopulmonary bypass.</p><p><b>Conclusion:</b> The prognosis for interrupted aortic arch depends on the associated congenital anomalies, but the outcome is usually very poor unless there is surgical treatment. Survival into adulthood depends on the development of collateral circulation.</p>

One-Stage Repair of Cardiac and Arch Anomalies without Circulatory Arrest

2003 ◽  
Vol 11 (3) ◽  
pp. 250-254 ◽  
Author(s):  
Kona Samba Murthy ◽  
Robert Coelho ◽  
Christopher Roy ◽  
Snehal Kulkarni ◽  
Benjamin Ninan ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Aortic Arch ◽  
Septal Defect ◽  
Circulatory Arrest ◽  
Coarctation Of The Aorta ◽  
Innominate Artery ◽  
Double Outlet Right Ventricle ◽  
Interrupted Aortic Arch ◽  
Ischemic Time ◽  
Arch Obstruction

Between 1999 and 2002, 23 patients underwent single-stage complete repair of cardiac anomalies and aortic arch obstruction, without circulatory arrest. Median age was 1.2 years. Intracardiac defects included ventricular septal defect in 9, double-outlet right ventricle in 6, d-transposition of the great arteries and ventricular septal defect in 2, subaortic obstruction in 3, and atrial septal defect in 3. Fourteen patients had coarctation of the aorta, 6 had coarctation with hypoplastic aortic arch, and 3 had interrupted aortic arch. Simple techniques were employed such as cannulation of the ascending aorta near the innominate artery and maintaining cerebral and myocardial perfusion. After correction of arch obstruction, intracardiac repair was undertaken. The mean cardiopulmonary bypass time was 169 min, aortic crossclamp time was 51 min, and arch repair took 16 min. There was no operative mortality or neurological deficit. In follow-up of 1–43 months, no patient had residual coarctation. This simplified technique avoids additional procedures, reduces ischemic time, and prevents problems related to circulatory arrest.

scholarly journals Structural Features in Tunica Media of the Aorta in Lamb

2017 ◽  
Vol 74 (1) ◽  
pp. 111
Author(s):  
Dalma CSIBI ◽  
Adrian Florin GAL ◽  
Cristian RATIU ◽  
Viorel MICLAUS
Keyword(s):  
Aortic Arch ◽  
Outer Part ◽  
Structural Features ◽  
Ascending Aorta ◽  
Tissue Samples ◽  
Descending Aorta ◽  
Tunica Media ◽  
Classic Pattern ◽  
The Media ◽  
Thoracic And Abdominal

In blood vessels situated just after the heart, an irregular blood flow occurs due to some specific structural elements of the tunica media. The current paper describes the histological aspects of some post-cardiac arterial sections in lamb. The tissue samples were collected from five 30 days old male lambs (Țurcană breed). Histological specimens from different regions of the aorta were harvested (i.e., the ascending aorta, aortic arch, thoracic and abdominal regions of the descending aorta). From the specified regions, small pieces (cca. 0.5 cm) were fixed in neutral 10% buffered formalin. The tissues were subsequently embedded in paraffin wax, sectioned at 5 μm, and stained with Goldner’s trichrome and Verhoeff methods. Tissue analysis was performed using an Olympus system for image acquisition and analysis. Histological appearance of the assessed segments of the aorta in lamb is unusual. Major changes occur in tunica media of the aorta. In the ascending aorta, aortic arch and thoracic regions of the aorta, the histological outline is somewhat the same. The internal region of the media possesses the typical lamellar arrangement. Concerning the outer part of tunica media, the smooth muscle has a tendency to form bundles of various sizes. The muscle islands are not present in the media of abdominal region of the aorta, which exhibits the classic pattern of elastic arteries.

Echocardiography of coarctation of the aorta, aortic arch hypoplasia, and arch interruption: strategies for evaluation of the aortic arch

2016 ◽  
Vol 26 (8) ◽  
pp. 1553-1562 ◽  
Author(s):  
Suma P. Goudar ◽  
Sanket S. Shah ◽  
Girish S. Shirali
Keyword(s):  
Aortic Arch ◽  
Coarctation Of The Aorta ◽  
The United States ◽  
Interrupted Aortic Arch ◽  
Hypoplastic Left Heart ◽  
Live Births ◽  
Additional Information ◽  
Non Invasive ◽  
Aortic Arch Hypoplasia

AimEchocardiography is the modality of choice for the diagnosis and serial follow-up of aortic arch pathology. In this article, we review the types of obstruction of the aortic arch, various classification schemes of coarctation of the aorta and interrupted aortic arch, methodology for optimal echocardiographic imaging of the aortic arch, and key echocardiographic measurements for accurate diagnosis of obstruction and hypoplasia of the aortic arch. Finally, we will discuss the limitations of echocardiography in optimal imaging of the aortic arch and the use of other non-invasive imaging modalities such as CT or MRI to provide additional information in these cases.BackgroundCoarctation of the aorta is the more common lesion of the two, with an estimated incidence of four in every 10,000 live births in the United States of America. Interrupted aortic arch is rarer, with an incidence of 19 per one million live births.1 There is a spectrum of pathology of obstruction of the aortic arch, ranging from coarctation of the aorta with and without hypoplasia of the arch to interrupted aortic arch. Both these lesions are frequently encountered in congenital cardiology practice, and will be discussed in the remainder of this article. Obstruction of the aortic arch in the setting of hypoplastic left heart structures or atresia of the aortic valve is beyond the scope of this review and will not be discussed further.

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