-
Pediatric Radiology Jun 2010Although anomalies of the aortic arch and its branches are relatively uncommon malformations, they are often associated with congenital heart disease. Isolated lesions... (Review)
Review
Although anomalies of the aortic arch and its branches are relatively uncommon malformations, they are often associated with congenital heart disease. Isolated lesions may be clinically significant when the airways are compromised by a vascular ring. In this article, the development and imaging appearance of the aortic arch system and its various malformations are reviewed.
Topics: Aorta, Thoracic; Female; Heart Defects, Congenital; Humans; Infant, Newborn; Magnetic Resonance Imaging; Male; Tomography, X-Ray Computed
PubMed: 20354848
DOI: 10.1007/s00247-010-1607-9 -
Interactive Cardiovascular and Thoracic... Nov 2022
Topics: Humans; Aorta, Thoracic; Thorax
PubMed: 36394267
DOI: 10.1093/icvts/ivac270 -
Cardiology Clinics Aug 2017Endovascular approaches to the aortic arch are challenged by unique anatomy and physiology of this area. Simple application of conventional endovascular technology and... (Review)
Review
Endovascular approaches to the aortic arch are challenged by unique anatomy and physiology of this area. Simple application of conventional endovascular technology and technique for abdominal or descending thoracic aortic disease to the aortic arch is insufficient to achieve effective and durable repairs. Appreciation of these challenges has led to developments in endovascular technology as well as complex strategies to deal with individual patient anatomy that hold the potential for continued improved outcomes in both the short and the long term.
Topics: Aorta, Thoracic; Blood Vessel Prosthesis Implantation; Endovascular Procedures; Hospitals, High-Volume; Humans; Stents; Treatment Outcome
PubMed: 28683906
DOI: 10.1016/j.ccl.2017.03.012 -
Seminars in Thoracic and Cardiovascular... 2009Transverse aortic arch hypoplasia involving some or all segments of the arch (tubular hypoplasia) may exist in association with intra-cardiac anomalies of varying... (Review)
Review
Transverse aortic arch hypoplasia involving some or all segments of the arch (tubular hypoplasia) may exist in association with intra-cardiac anomalies of varying severity. Surgical repair of the distal transverse aortic arch and isthmus are adequately managed by an extended end-to-end coarctation repair in most infants via a left thoracotomy. The surgical management and timing of proximal aortic arch obstruction is controversial but almost always requires an approach via sternotomy using cardiopulmonary bypass.
Topics: Aorta, Thoracic; Aortic Coarctation; Cardiac Surgical Procedures; Cardiopulmonary Bypass; Heart Defects, Congenital; Humans; Infant, Newborn
PubMed: 19349017
DOI: 10.1053/j.pcsu.2009.01.024 -
The Journal of Thoracic and... Oct 2023
Topics: Humans; Aorta, Thoracic; Aortic Aneurysm, Thoracic; Treatment Outcome
PubMed: 35337676
DOI: 10.1016/j.jtcvs.2022.02.034 -
Seminars in Pediatric Surgery Dec 2021Vascular rings are congenital aortic arch anomalies that lead to compression of the trachea or esophagus. The goal of this review is to summarize our current... (Review)
Review
Vascular rings are congenital aortic arch anomalies that lead to compression of the trachea or esophagus. The goal of this review is to summarize our current recommendations for the management of patients with a diagnosis of a vascular ring. We review the history, classification methods, and epidemiology of the various types of vascular rings. We then propose a management strategy for the relatively new paradigm of fetal diagnosis, including the management of asymptomatic vascular rings. Finally, we finish with a review of the operative techniques and outcomes for the four main categories of vascular rings.
Topics: Aorta, Thoracic; Esophagus; Heart Defects, Congenital; Humans; Subclavian Artery; Vascular Ring
PubMed: 34930596
DOI: 10.1016/j.sempedsurg.2021.151128 -
Journal of Ultrasound in Medicine :... Feb 2016Aortic arch anomalies are present in 1% to 2% of the general population and are commonly associated with congenital heart disease, chromosomal defects, and... (Review)
Review
Fetal Aortic Arch Anomalies: Key Sonographic Views for Their Differential Diagnosis and Clinical Implications Using the Cardiovascular System Sonographic Evaluation Protocol.
Aortic arch anomalies are present in 1% to 2% of the general population and are commonly associated with congenital heart disease, chromosomal defects, and tracheaesophageal compression in postnatal life. The sonographically based detection of aortic arch anomalies lies in the 3-vessel and trachea view. Although highly sensitive, this view alone does not allow identification of the aortic arch branching pattern, which prevents an accurate diagnosis. The systematic addition of a subclavian artery view as part of a standardized procedure may be useful in the differential diagnosis of these conditions. We describe the sonographic assessment of fetal aortic arch anomalies by combining 2 fetal transverse views: the 3-vessel and trachea view and the subclavian artery view, which are included in the cardiovascular system sonographic evaluation protocol. We also review the sonographic findings and the clinical implications of fetal aortic arch anomalies.
Topics: Aorta, Thoracic; Cardiovascular System; Clinical Protocols; Diagnosis, Differential; Female; Humans; Pregnancy; Ultrasonography, Prenatal
PubMed: 26715656
DOI: 10.7863/ultra.15.02063 -
Multimedia Manual of Cardiothoracic... Jun 2021One category of vascular rings is the right aortic arch associated with the diverticulum of Kommerell from which the left subclavian artery usually originates. In some...
One category of vascular rings is the right aortic arch associated with the diverticulum of Kommerell from which the left subclavian artery usually originates. In some cases, the right aortic arch crosses behind the trachea and the esophagus from right to left. The trachea and esophagus are compressed by the right aortic arch, the left ligamentum, and the posterior crossing aorta, which causes the typical symptoms of noisy breathing, dyspnea on exertion, dysphagia, and frequent upper respiratory tract infections. Division of the atretic arch segment between the diverticulum of Kommerell and the left common carotid artery may relieve the symptoms temporarily but does not relieve the compression produced by this vascular abnormality. Indeed, at the age of 10 months, this patient underwent anterior arch division and posterior aortopexy via a posterolateral thoracotomy in order to relieve the compression caused by the vascular ring. Several months after the initial operation, the patient had recurrent respiratory symptoms as a result of residual vascular compression from the circumflex arch. A CT scan and airway endoscopy confirmed tracheal compression; in addition, the tracheoscopy showed tracheomalacic changes in the compressed segment of the trachea. To relieve the symptoms and the compression, we decided to resect the tracheomalacic segment of the trachea and translocate the aortic arch anterior to the trachea and esophagus.
Topics: Aorta, Thoracic; Child, Preschool; Humans; Postoperative Complications; Respiratory Insufficiency; Trachea
PubMed: 34157220
DOI: 10.1510/mmcts.2021.036 -
Journal of Cardiovascular Magnetic... 2006Magnetic resonance imaging has become the gold standard for imaging the aortic arch with the ability to demonstrate not only the arterial branching pattern, but also the...
Magnetic resonance imaging has become the gold standard for imaging the aortic arch with the ability to demonstrate not only the arterial branching pattern, but also the relationship of aorta and its branches to the trachea and bronchi. Examples of four major aortic arch types--left aortic arch, right aortic arch, double aortic arch and persistent fifth aortic--with most of their variations are demonstrated.
Topics: Aorta, Thoracic; Heart Defects, Congenital; Humans; Magnetic Resonance Imaging
PubMed: 16869315
DOI: 10.1080/10976640600713756 -
Seminars in Cardiothoracic and Vascular... Sep 2018Interrupted aortic arch (IAA) is defined as the loss of luminal continuity between the ascending and descending aorta and is classified based on the anatomic level of... (Review)
Review
Interrupted aortic arch (IAA) is defined as the loss of luminal continuity between the ascending and descending aorta and is classified based on the anatomic level of interruption. IAA is associated with a number of intracardiac anomalies with the most common being patent ductus arteriosus, ventricular septal defect, and left ventricular outflow obstruction. There is also a strong association between type B interruption and 22q11 deletion syndrome. The perioperative management of the neonate with IAA begins in the intensive care unit with optimization of end-organ perfusion and function. Survival depends on the prompt initiation of prostaglandin E1 in order to maintain ductal patency, careful management of the patient's ratio of pulmonary to systemic blood flow (Qp:Qs), and a thorough understanding of the physiologic implications of the surgical plan, type of interruption, and associated syndromes and anomalies. This review will focus on the anatomy, physiology, and perioperative anesthetic management considerations specific to the management of IAA.
Topics: Anesthesia; Aorta, Thoracic; Heart Defects, Congenital; Humans; Infant, Newborn; Perioperative Care
PubMed: 29742969
DOI: 10.1177/1089253218775954