Surgical treatment of double-lumen aortic arch (persistent fifth aortic arch) associated with severe aortic coarctation

Persistent fifth aortic arch (PFAA) is a rare anomaly often associated with aortic coarctation or interruption, and various surgical techniques for this anomaly have been reported. Herein, we show a case of an infant with PFAA and severe aortic coarctation. The aortic arch was reconstructed using end-to-side anastomosis between the fifth aortic arch and the descending aorta without any artificial conduit or patching material. This approach is easy and effective, has growth potential, and an additional surgery is not needed in the future.

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Persistent fifth aortic arch associated with aortic coarctation: a case of surgical correction without artificial material

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01664-y ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Chang Hun Kim ◽

Hyungtae Kim ◽

Kwang Ho Choi ◽

Si Chan Sung ◽

Hoon Ko ◽

...

Keyword(s):

Aortic Arch ◽

Aortic Coarctation ◽

Surgical Intervention ◽

Surgical Techniques ◽

Growth Potential ◽

Case Presentation ◽

Descending Aorta ◽

Persistent Fifth Aortic Arch ◽

Additional Surgery ◽

Surgical Methods

Abstract Background Persistent fifth aortic arch (PFAA) is a rare anomaly often associated with aortic coarctation or interruption, and various surgical techniques for this anomaly have been reported. Herein, we show a case of an infant with PFAA and severe aortic coarctation. Case presentation A 41-day-old female infant was admitted for sustained fever. Initially, the patient was diagnosed with bacterial meningitis, and echocardiography showed PFAA with severe aortic coarctation. Because the patient presented progressive oliguria and metabolic acidosis, she was transferred for emergency cardiac surgical intervention. The aortic arch was reconstructed using end-to-side anastomosis between the fifth aortic arch and the descending aorta without any artificial conduit or patching material. Conclusions PFAA with aortic coarctation can be repaired by various surgical methods. Among them, our surgical approach is easy and effective, has growth potential, and an additional surgery is not needed.

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Persistent Fifth Aortic Arch Associated With Aortic Coarctation: A Case of Surgical Correction Without Artificial Material

10.21203/rs.3.rs-151066/v1 ◽

2021 ◽

Author(s):

Chang Hun Kim ◽

Hyungtae Kim ◽

Kwang Ho Choi ◽

Si Chan Sung ◽

Hoon Ko ◽

...

Keyword(s):

Aortic Arch ◽

Aortic Coarctation ◽

Surgical Intervention ◽

Surgical Techniques ◽

Growth Potential ◽

Case Presentation ◽

Descending Aorta ◽

Persistent Fifth Aortic Arch ◽

Additional Surgery ◽

Surgical Methods

Abstract Background: Persistent fifth aortic arch (PFAA) is a rare anomaly often associated with aortic coarctation or interruption, and various surgical techniques for this anomaly have been reported. Herein, we show a case of an infant with PFAA and severe aortic coarctation. Case presentation: A 41-day-old female infant was admitted for sustained fever. Initially, the patient was diagnosed with bacterial meningitis, and echocardiography showed PFAA with severe aortic coarctation. Because the patient presented progressive oliguria and metabolic acidosis, she was transferred for emergency cardiac surgical intervention. The aortic arch was reconstructed using end-to-side anastomosis between the fifth aortic arch and the descending aorta without any artificial conduit or patching material. Conclusions: PFAA with aortic coarctation can be repaired by various surgical methods. Among them, our surgical approach is easy and effective, has growth potential, and an additional surgery is not needed.

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Interrupted fourth aortic arch with persistent fifth aortic arch and aortic coarctation—treatment with balloon angioplasty combined with surgery

Cardiology in the Young ◽

10.1017/s1047951100011239 ◽

1994 ◽

Vol 4 (3) ◽

pp. 304-306 ◽

Cited By ~ 2

Author(s):

Raul Jurí ◽

Luis Eduardo Alday ◽

Roberto De Rossi

Keyword(s):

Aortic Arch ◽

Subclavian Artery ◽

Balloon Angioplasty ◽

Aortic Coarctation ◽

Left Subclavian Artery ◽

Balloon Dilation ◽

Descending Aorta ◽

Persistent Fifth Aortic Arch

AbstractA symptomatic neonate was referred for aortic coarctation and, at cineangiography, was shown to have an interruption of the aortic arch at the isthmus together with coarctation related to a persistent fifth aortic arch. Balloon dilation of the coarctation was performed, but the coarctation was still evident after six months. A graft was then interposed between the left subclavian artery and the descending aorta. Balloon dilation was repeated five years later leaving a residual gradient of 11 mm Hg.

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Surgical Treatment of Persistent Fifth Aortic Arch Associated with Interrupted Aortic Arch

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2007.04.030 ◽

2007 ◽

Vol 84 (3) ◽

pp. 1016-1019 ◽

Cited By ~ 17

Author(s):

Yong-Hong Zhao ◽

Zhao-Kang Su ◽

Jin-Feng Liu ◽

Ding-Fang Cao ◽

Wen-Xiang Ding

Keyword(s):

Surgical Treatment ◽

Aortic Arch ◽

Interrupted Aortic Arch ◽

Persistent Fifth Aortic Arch

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Abnormal histology of the aortic arch in coarctation of the aorta

Cardiology in the Young ◽

10.1017/s1047951100001852 ◽

1993 ◽

Vol 3 (4) ◽

pp. 412-416 ◽

Cited By ~ 3

Author(s):

Derk W. Wolterbeek ◽

Arie P. Kappetein ◽

Adriana C. Gittenberger–de Groot

Keyword(s):

Neural Crest ◽

Aortic Arch ◽

Aortic Coarctation ◽

Coarctation Of The Aorta ◽

Lower Number ◽

Descending Aorta ◽

Aortic Isthmus ◽

Cardiac Neural Crest ◽

The Media

SummaryWe examined the number of elastic lamellae in the wall of the proximal aortic arch, aortic isthmus and descending aorta in patients with coarctation of the aorta. In the proximal aortic arch, the number of elastic lamellae was significantly lower in patients with coarctation compared to those with normal hearts without aortic anomalies and those with intracardiac defects but without aortic anomalies. The isthmus also showed a significantly lower number of elastic lamellae in the presence of preductal coarctation. In the descending aorta, the number of elastic lamellae was not significantly different between the different groups. There is doubt about the etiology of coarctation. Recent investigations showed that cells from the cardiac neural crest contribute to the formation of the arch arteries and the media of the arch. A developmental error of the neural crest might be responsible for the abnormal mural structures found in patients with aortic coarctation.

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A clinical case of hybrid surgical treatment of aortic arch saccular aneurysm in a patient with newly diagnosed aortic coarctation

Russian Journal of Cardiology ◽

10.15829/1560-4071-2018-11-130-132 ◽

2018 ◽

pp. 130-132

Author(s):

M. A. Chernyavsky ◽

N. N. Zherdev ◽

D. V. Chernova ◽

A. V. Chernov ◽

Yu. A. Kudaev ◽

...

Keyword(s):

Surgical Treatment ◽

Aortic Arch ◽

Aortic Coarctation ◽

Clinical Case ◽

Saccular Aneurysm ◽

Newly Diagnosed

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Postoperative aneurysm after aortic coarctation repair in patient with the right aortic arch: repeated surgery in the presence of the rare anomaly

Kreativnaya kardiologiya ◽

10.15275/kreatkard.2015.03.07 ◽

2015 ◽

pp. 79-84

Author(s):

Valery Arakelyan ◽

◽

Nikita Gidaspov ◽

Inna Chshieva ◽

Pavel Kulichkov

Keyword(s):

Aortic Arch ◽

Aortic Coarctation ◽

Right Aortic Arch ◽

Rare Anomaly ◽

Coarctation Repair ◽

Repeated Surgery ◽

The Right

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A persistent fifth aortic arch in man: A double-lumen aortic arch (presentation of a new case and review of the literature)

Pediatric Cardiology ◽

10.1007/bf02427540 ◽

1987 ◽

Vol 8 (4) ◽

pp. 265-269 ◽

Cited By ~ 21

Author(s):

Marcos A. Herrera ◽

Vincent J. D'Souza ◽

Kerry M. Link ◽

Kenneth M. Weesner ◽

Augustin G. Formanek

Keyword(s):

Aortic Arch ◽

Review Of The Literature ◽

Double Lumen ◽

Persistent Fifth Aortic Arch

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Insertion of a bypass graft from carotid artery to descending aorta in the management of aortic coarctation with severe hypoplasia of the aortic arch—a report of two cases

Cardiology in the Young ◽

10.1017/s1047951100010702 ◽

1993 ◽

Vol 3 (1) ◽

pp. 76-78

Author(s):

Ganga Prabhakar ◽

Naresh Kumar ◽

Zohair Al Halees ◽

Neil Wilson

Keyword(s):

Surgical Technique ◽

Carotid Artery ◽

Aortic Arch ◽

Aortic Coarctation ◽

Bypass Graft ◽

Descending Aorta ◽

Residual Stenosis ◽

Cardiac Abnormalities ◽

Standard Procedures ◽

The Individual

AbstractRepair of severe hypoplasia of the aortic arch with coarctation must be based on the individual anatomy of the lesion and, where necessary, one should take into consideration associated cardiac abnormalities. We report a surgical technique which was employed when standard procedures for reconstruction of the arch had failed to relieve the obstruction adequately. A conduit from the carotid artery to the descending aorta was used successfully in two patients to abolish residual stenosis.

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Aortic arch advancement for type A interrupted aortic arch with persistent fifth aortic arch type B

Cardiology in the Young ◽

10.1017/s1047951117000051 ◽

2017 ◽

Vol 27 (5) ◽

pp. 1018-1021 ◽

Cited By ~ 1

Author(s):

Ziyad M. Binsalamah ◽

Peter Chen ◽

Emmett D. McKenzie

Keyword(s):

Congenital Diaphragmatic Hernia ◽

Aortic Arch ◽

Diaphragmatic Hernia ◽

Type A ◽

Interrupted Aortic Arch ◽

Type B ◽

Postoperative Course ◽

Left Thoracotomy ◽

Persistent Fifth Aortic Arch ◽

Rare Anomaly

AbstractPersistence of the fifth aortic arch is a very rare anomaly, but is clinically relevant when it is associated with coarctation. We report a case of a neonate with type A interrupted aortic arch and severe coarctation of a persistent fifth aortic arch, which was discovered after repair of a left congenital diaphragmatic hernia. The combination of anomalies was discovered intra-operatively following left thoracotomy, and was treated with aortic arch advancement. The postoperative course was uneventful.

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