Variants of the Aortic Arch in Adult General Population and their Association with Thoracic Aortic Aneurysm Disease

Background. Query a single institution computed tomography (CT) database to assess the prevalence of aortic arch anomalies in general adult population and their potential association with thoracic aortopathies. Methods. CT chest scan reports of patients aged 50-85 years old performed for any indication at a single health system between 2013 and 2016 were included in the analysis. Characteristics of patients with and without aortic arch anomalies were compared by t-test and Fisher exact tests. Logistic regression analysis was performed to assess for independent risk factors of thoracic aortic aneurysm. Results. Of 21,336 CT scans, 603 (2.8%) described arch anomalies. Bovine arch (n=354, 58.7%) was the most common diagnosis. Patients with arch anomalies were more likely to be female (p<0.001), non-Caucasian(p<0.001), and hypertensive (p<0.001). Prevalence of thoracic aortic aneurysm in arch anomalies group was 10.8% (n=65) compared to 4.1% (n=844) in the non-arch anomaly cohort (p<0.001). The highest prevalence of thoracic aneurysm was associated with right-sided arch combined with aberrant left subclavian configuration (33%), followed by bovine arch (13%), and aberrant right subclavian artery (8.2%). On binary logistic regression, arch anomaly (OR=2.85 [2.16-3.75]), aortic valve pathology (OR 2.93 [2.31-3.73]), male sex (OR 2.38 [2.01-2.80]), and hypertension (OR 1.47 [1.25-1.73]) were significantly associated with increased risk of thoracic aneurysm disease. Conclusions. Reported prevalence of aortic arch anomalies by CT imaging in the older adult population is ~3%, with high association of thoracic aortic aneurysm (OR=2.85) incidence in this subgroup. This may warrant a more tailored surveillance strategy for aneurysm disease in this subpopulation.

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Hybrid Treatment Option for Aortic Arch Anomalies and Descending Thoracic Aortic Aneurysm

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2013.03.031 ◽

2013 ◽

Vol 24 (7) ◽

pp. 1063-1065 ◽

Cited By ~ 1

Author(s):

Nicola Mangialardi ◽

Sonia Ronchey ◽

Holta Kasemi ◽

Vittorio Alberti ◽

Eugenia Serrao

Keyword(s):

Aortic Aneurysm ◽

Aortic Arch ◽

Treatment Option ◽

Thoracic Aortic Aneurysm ◽

Aortic Arch Anomalies ◽

Descending Thoracic Aortic Aneurysm ◽

Hybrid Treatment

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Aortic Arch Replacement for Thoracic Aortic Aneurysm Combined with Aberrant Right Subclavian Artery: Two Case Reports

Japanese Journal of Cardiovascular Surgery ◽

10.4326/jjcvs.36.88 ◽

2007 ◽

Vol 36 (2) ◽

pp. 88-91 ◽

Cited By ~ 5

Author(s):

Hitoshi Kanamitsu ◽

Hidenori Yoshitaka ◽

Masahiko Kuinose ◽

Yoshimasa Tsushima ◽

Hitoshi Minami ◽

...

Keyword(s):

Aortic Aneurysm ◽

Aortic Arch ◽

Subclavian Artery ◽

Thoracic Aortic Aneurysm ◽

Case Reports ◽

Aberrant Right Subclavian Artery ◽

Aortic Arch Replacement

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

Cardiovascular Ultrasound ◽

10.1186/s12947-021-00237-2 ◽

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.

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