Aneurysm of Right Cervical Aortic Arch with Abnormal Branching Pattern

1998 ◽  
Vol 6 (2) ◽  
pp. 135-137
Author(s):  
Sandeep Shrivastava ◽  
Shipra Shrivastava ◽  
Kurur Sankaran Neelakandhan
Keyword(s):  
Cardiopulmonary Bypass ◽  
Carotid Artery ◽  
Aortic Arch ◽  
Rare Case ◽  
Circulatory Arrest ◽  
Innominate Artery ◽  
Ascending Aorta ◽  
Branching Pattern ◽  
The Right ◽  
Total Circulatory Arrest

We report a rare case of congenital saccular aneurysm of the right cervical aortic arch in a 16-year-old girl. There were no branches arising from the aortic arch but 3 branches arose from the ascending aorta: the left innominate artery, the right common carotid artery, and the right subclavian artery. The aneurysm was successfully repaired with a plasma-preclotted woven Dacron interposition graft during profound hypothermic cardiopulmonary bypass without total circulatory arrest.

scholarly journals Percutaneous or Side-Arm Graft Right Subclavian Artery Cannulation via Median Sternotomy

Aorta ◽  
2019 ◽  
Vol 07 (05) ◽  
pp. 150-153
Author(s):  
Corrado Cavozza ◽  
Antonio Campanella ◽  
Pellegrino Pasquale ◽  
Andrea Audo
Keyword(s):  
Cardiopulmonary Bypass ◽  
Subclavian Artery ◽  
Circulatory Arrest ◽  
Median Sternotomy ◽  
Innominate Artery ◽  
Bypass Flow ◽  
Surgical Incision ◽  
Artery Cannulation ◽  
The Right ◽  
Antegrade Cerebral Perfusion

AbstractSeveral cannulation sites alternative to the ascending aorta, such as femoral, right axillary, carotid, innominate artery, and, less commonly, apical sites, have been proposed. Cannulation of the right subclavian artery, through sternotomy, is one possible means of establishing cardiopulmonary bypass, hence avoiding a second surgical incision. In our experience, cardiopulmonary bypass flow was adequate and circulatory arrest with antegrade cerebral perfusion was successfully performed in all cases. There was no in-hospital mortality.

scholarly journals Morphometry of the aortic arch and its branches

2013 ◽  
Vol 19 (3) ◽  
pp. 154-159 ◽  
Author(s):  
A.M. Manole ◽  
D.M. Iliescu ◽  
A. Rusali ◽  
P. Bordei
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Left Subclavian Artery ◽  
Ascending Aorta ◽  
Ct Scanner ◽  
Arterial Trunk ◽  
Brachiocephalic Trunk ◽  
The Right

Abstract Our study was conducted by the evaluation of angioCT’s performed on a GE LightSpeed VCT64 Slice CT Scanner. The measurements were performed on the aortic arch at the following levels: at the origin of the aorta, the middle part of the ascending aorta, prior to the origin of the brachiocephalic arterial trunk and after the origin of the left subclavian artery. We measured the caliber of the aortic arch arteries and the data are correlated and reported by gender. The diameter of the ascending aorta was between 27 to 28.9 mm in females and in males from 25.8 to 37.6 mm. The diameter of the aorta within the middle segment of the ascending part was between 28-30.2 mm in females and in males from 26.1 to 34.6. The diameter of the aortic arch prior to the origin of the brachiocephalic arterial trunk was between 26.4 to 29.4 mm in females and in males from 25.8 to 37.5 mm. The diameter of the aortic arch after the origin of the left subclavian artery was in a range of 20.4 to 28.4 mm, which corresponds to the limits found in males while in females the aortic diameter was between 21.3 to 24.1 mm. The brachiocephalic trunk diameters were 8.3 to 15.5 mm in females and in males was 9.1 to 14.5 mm. The right common carotid artery had a diameter of 4-8 mm diameter in males and in females ranged from 4.7 to 5.5 mm. The right subclavian artery showed a caliber of 5.7 to 7.5 mm in females and in males from 5.9 to 10.1. The left common carotid artery diameter was 4.6 to 5.7 mm in females and males the diameter was between 5.2 to 7.4 mm. The left subclavian artery had a diameter of 6-10 mm in females and in males ranged from 7.7 to 12.8 mm. We found that the distance between the ascending part of the aorta and the descending segment ranged from 33.3 to 38.5 mm in females and in males from 40 to 68.6 mm. We measured the distance that exists at the crossing of the aortic arch with the left branch of the pulmonary trunk, finding that in females this distance is 3 to 10.3 mm and in males from 3 to 12.5 mm.

scholarly journals INNOMINATE ARTERY CANNULATION FOR PROXIMAL AORTIC SURGERY

2020 ◽  
Author(s):  
Bülent Mert ◽  
kamil boyacıoğlu ◽  
Hakan Sacli ◽  
Berk Özkaynak ◽  
Ibrahim Kara ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Cerebral Perfusion ◽  
Circulatory Arrest ◽  
Aortic Surgery ◽  
Innominate Artery ◽  
Arterial Injury ◽  
Ascending Aorta ◽  
Artery Cannulation ◽  
The Mean ◽  
Antegrade Cerebral Perfusion

Background. The aim of this study was to evaluate the efficacy and safety of innominate artery cannulation strategy with side graft technique in proximal aortic pathologies. Methods. A total of 70 patients underwent innominate artery cannulation with a side graft for surgery on the proximal aorta from 2012 to 2020. There were 46 men and 24 women with an avarage age of 56 ±13 years. The indications of surgery were type A aortic dissection in 17 patients (24.3%), aortic aneurysm in 52 patients (74.3%) and ascending aorta pseudoaneurysm in 1 patient (1.4%). The innominate artery was free of disease in all patients. Hypothermic circulatory arrest with antegrade cerebral perfusion was utilized in 60 patients (85.7%). 3 patients had previous sternotomy (4.2%). The most common surgical procedure was ascending aorta and hemiarch replacement in 34 patients (48.5%). Results. The mean cardiac ischemia and cardiopulmonary bypass times were 116+46 minutes and164+56 minutes, respectively. The mean antegrade cerebral perfusion time was 27+14 minutes. The patients were cooled between 22’C and 30’C during surgery. 30-day mortality rate was 7.1% with 5 patients. 1 patient (1.4%) had stroke, 1 patient (1.4%) had temporary neurologic deficit and 8 patients (11.4%) had confusion and agitation that resolved completely in all cases. There was no local complication or arterial injury was encounterd. Conclusions. Cannulation of the innominate artery with side graft is safe and effective for both cardiopulmonary bypass and antegrade cerebral perfusion. This technique provides excellent neurologic outcomes for proximal aortic surgery.

ARCH Replacement in Acute Aortic Dissection Type a in Normothermia

2001 ◽  
Vol 71 (3) ◽  
pp. 282-286
Author(s):  
Ovidiu Stiru ◽  
Roxana Carmen Geana ◽  
Adrian Tulin ◽  
Raluca Gabriela Ioan ◽  
Victor Pavel ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Ct Scan ◽  
Aortic Arch ◽  
Acute Aortic Dissection ◽  
Circulatory Arrest ◽  
Type A ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
The Right ◽  
Aortic Dissection Type A

The purpose of this case presentation is to present a simplified surgical technique when in a patient with acute aortic dissection type A (AAD), aortic arch, and ascending aorta is completely replaced without circulatory arrest. A 67-year old male was presented in our institution with severe chest and back pain at 12 h after the onset of the symptoms. Imaging studies by 3D contrast-enhanced thoracic computed tomography (CT-scan) and transesophageal echocardiography (TEE) revealed ascending aortic dissection towards the aortic arch, which was extending in the proximal descending aorta. We practiced emergency median sternotomy and established cardiopulmonary bypass (CBP) between the right atrium and the right femoral artery with successive cross-clamping of the ascending and descending aorta below the origin of the left subclavian artery (LSA). In normothermic condition without circulatory arrest and with antegrade cerebral perfusion, we replaced the ascending aorta and aortic arch with a four branched Dacron graft. Patient evolution was uneventful, and he was discharged, after fourteen days from the hospital. At a one-year follow-up, 3D CT-scan showed no residual dissection with a well-circulated lumen of the supra-aortic arteries. Using the described surgical approach, CPB was not interrupted, the brain was protected, and hypothermia was no used. This approach made these surgical procedures shorter, and known complications of hypothermia and circulatory arrest are avoided.Acute aortic dissection aortic type A, total arch replacement, normothermia

scholarly journals XXII. The development of the branchial arterial arches in birds, with special reference to the origin of the subclavians and carotids

1887 ◽  
Vol 42 (251-257) ◽  
pp. 429-432 ◽  
Keyword(s):  
Carotid Artery ◽  
Special Reference ◽  
Aortic Arch ◽  
Aortic Root ◽  
Common Carotid Artery ◽  
Innominate Artery ◽  
Adult Bird ◽  
Basal Portion ◽  
The Common ◽  
The Right

According to the theories of Rathke, which are universally accepted at the present day, the subclavian artery is supposed to take its origin from the aortic root or fourth embryonic branchial arterial arch. In the adult bird the subclavian on each side is found springing from, the extremity of an innominate artery along with the common carotid. It is presumed that the right subclavian has been, by a shortening of the aortic arch, carried forwards until it meets and fuses with the base of the common carotid artery; and the left subclavian is regarded as representing by its basal portion the fourth left arch or left primitive aorta.

Incomplete isolation of the left innominate artery from the right aortic arch: a rare case of double-outlet right ventricle with pulmonary stenosis

2019 ◽  
Vol 29 (5) ◽  
pp. 717-719
Author(s):  
Jun Sato ◽  
Atsuko Kato ◽  
Naoki Ohashi
Keyword(s):  
Right Ventricle ◽  
Aortic Arch ◽  
Rare Case ◽  
Surgical Repair ◽  
Pulmonary Stenosis ◽  
Innominate Artery ◽  
Double Outlet Right Ventricle ◽  
Right Aortic Arch ◽  
Female Infant ◽  
The Right

AbstractIsolation of the left innominate artery from the right aortic arch is a rare anomaly. Herein, we present an even rarer case of incomplete isolation of the proximal left innominate artery with the right aortic arch in a 3-month-old female infant with a double-outlet right ventricle and pulmonary stenosis. Surgical repair at 6 months of age was successful, leading to the restoration of adequate flow in the left arm.

scholarly journals A Rare Case of Persistent Flow Reversal in the Vertebral and Carotid Arteries

2003 ◽  
Vol 27 (1) ◽  
pp. 55-59
Author(s):  
Teresa Tice ◽  
Terry Rolan ◽  
Craig Cannon
Keyword(s):  
Carotid Artery ◽  
Rare Case ◽  
Carotid Arteries ◽  
Innominate Artery ◽  
Flow Reversal ◽  
The Right

Several types of steal syndromes have been described. We report here a case of persistent flow reversal in the right vertebral and carotid artery systems associated with occlusion of the innominate artery.

Innominate Artery Cannulation for Aortic Surgery

2007 ◽  
Vol 15 (4) ◽  
pp. 348-350 ◽  
Author(s):  
Kuan-Ming Chiu ◽  
Shao-Jung Li ◽  
Tzu-Yu Lin ◽  
Chih-Yang Chan ◽  
Shu-Hsun Chu
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Axillary Artery ◽  
Aortic Surgery ◽  
Innominate Artery ◽  
Ascending Aorta ◽  
Effective Alternative ◽  
Artery Cannulation ◽  
Aortic Cannulation

When disease involving the ascending aorta or aortic arch precludes ascending aortic cannulation, axillary artery cannulation is used for cardiopulmonary bypass. An additional incision and the relatively small caliber of the axillary artery are the drawbacks of this approach. Innominate artery cannulation using the same sternotomy wound is a simple and effective alternative.

Pseudoaneurysm Fistulated into the Right Atrium after Double Valve Replacement

2015 ◽  
Vol 18 (4) ◽  
pp. 143
Author(s):  
Hiromu Kehara ◽  
Tamaki Takano ◽  
Kazunori Komatsu ◽  
Takamitsu Terasaki ◽  
Kenji Okada
Keyword(s):  
Computed Tomography ◽  
Cardiopulmonary Bypass ◽  
Valve Replacement ◽  
Right Atrium ◽  
Rare Case ◽  
Femoral Vein ◽  
Ascending Aorta ◽  
Double Valve Replacement ◽  
Left Femoral Artery ◽  
The Right

We discuss a rare case of an ascending aorta pseudoaneurysm fistulating into the right atrium following prior aortic and mitral valve replacement. Transthoracic echocardiography and computed tomography revealed a pseudoaneurysm of the ascending aorta attached to the right atrium with fistulous communication. The pseudoaneurysm arose from the center of the former aortotomy. Emergency remedian sternotomy was performed without aneurysmal injury and with exposure of the left femoral artery and femoral vein. Aneurysmal resection and ascending aorta repair were performed without complication. Exposing peripheral vessels, and initiating cardiopulmonary bypass only after reentry, might be effective in resternotomy to approach ascending aorta pseudoaneurysms.<br /><br />

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