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Journal of Clinical Medicine Mar 2022Abnormalities of the left brachiocephalic vein (LBCVA) are rare and poorly studied prenatally. An association with congenital heart defects (CHD), extracardiac and... (Review)
Review
Abnormalities of the left brachiocephalic vein (LBCVA) are rare and poorly studied prenatally. An association with congenital heart defects (CHD), extracardiac and genetic abnormalities was described. The aim of our study was to estimate the rate and summarize the available evidence concerning prenatal diagnosis, associated anomalies, and outcomes of these anomalies. A systematic literature review was carried out selecting studies reporting on prenatal diagnosis of LBCVA, including unpublished cases from our experience. Frequencies were pooled from cohort studies to calculate prenatal incidence. Pooled proportions were obtained from all the studies including rates of associated CHD, extracardiac or genetic abnormalities and neonatal outcomes. The search resulted in the selection of 16 studies with 311 cases of LBCVA, with an incidence of 0.4% from six cohort studies. CHD occurred in 235/311 (75.6%) fetuses: 23 (7.4%) were major in cases of double, retroesophageal or subaortic course and 212 (68.2%) were minor in cases of absence (always associated with a persistent left superior vena cava) or intrathymic course. Data on other associated outcomes were scarce showing rare extracardiac anomalies (3.5%), rare genetic abnormalities (RASopathies and microdeletions associated with the retroesophageal course), and neonatal outcomes favorable in most cases, particularly in intrathymic forms.
PubMed: 35407413
DOI: 10.3390/jcm11071805 -
Okajimas Folia Anatomica Japonica 2017In a student course of gross anatomy dissection at Kanagawa Dental University in 2011, we encountered anomalous case of the right subclavian artery arising from the... (Review)
Review
In a student course of gross anatomy dissection at Kanagawa Dental University in 2011, we encountered anomalous case of the right subclavian artery arising from the aortic arch as the last branch in an 84-year-old Japanese male cadaver. The anomalous artery ran obliquely upward, passed behind the esophagus and trachea, and ultimately ran toward right scalene gap. The area of distribution of the anomalous artery was normal. We report a case of retroesophageal right subclavian artery, and discuss its development, or relation with the thoracic duct, and its clinical importance. Despite this type of variation being relatively rare, reports on such a case have been accumulating. Owing to the recent development of CT and MRI, the number of clinical reports on this anomaly has been increasing.
Topics: Aged, 80 and over; Humans; Male; Recurrent Laryngeal Nerve; Subclavian Artery
PubMed: 29681591
DOI: 10.2535/ofaj.94.75 -
Surgical and Radiologic Anatomy : SRA Sep 2021A rare branching pattern of the aortic arch in a female cadaver is reported. An aberrant right subclavian artery originated from the distal part of the aortic arch and...
A rare branching pattern of the aortic arch in a female cadaver is reported. An aberrant right subclavian artery originated from the distal part of the aortic arch and following a retroesophageal course was recognized. Next to it, from the left to the right, the left subclavian artery and a short bicarotid trunk originating the left and the right common carotid artery were recognized. An unusual origin of the vertebral arteries was also identified. The left vertebral artery originated directly from the aortic arch, whereas the right vertebral artery originated directly from the right common carotid artery. Retroesophageal right subclavian artery associated with a bicarotid trunk and ectopic origin of vertebral arteries represents an exceptional and noteworthy case.
Topics: Cadaver; Cardiovascular Abnormalities; Carotid Arteries; Female; Humans; Subclavian Artery; Vertebral Artery
PubMed: 33856505
DOI: 10.1007/s00276-021-02746-1 -
Scientific Reports Oct 2018The purpose of this study was to report fetal cases of subaortic and retroesophageal anomalous courses of the left brachiocephalic vein (LBCV) evaluated by fetal cardiac...
The purpose of this study was to report fetal cases of subaortic and retroesophageal anomalous courses of the left brachiocephalic vein (LBCV) evaluated by fetal cardiac magnetic resonance imaging (MRI). A retrospective review of 7282 fetal cardiac MRI from June 2006 to March 2017, nine cases of anomalous courses of the LBCV were correctly diagnosed by fetal cardiac MRI, one case of abnormal subaortic left brachiocephalic vein (ASLBV) missed by fetal MRI was identified postnatally during further imaging of the TOF. The diagnosis was confirmed postnatally by cardiac CT/MRI. An ASLBV was found in 8 cases, a retroesophageal LBCV was found in 2 additional cases with right aortic arch and aberrant left subclavian artery. 3 of 8 ASLBV cases were with a right aortic arch, 4 ASLBV cases had additional cardiovascular anomalies with one case isolated. 7 of 8 ASLBV and 2 retroesophageal LBCV were correctly diagnosed by fetal cardiac MRI; however fetal cardiac MRI missed 2 cases of associated pulmonary atresia (PA). Prenatal echocardiography (echo) correctly diagnosed five ASLBV and one retroesophageal LBCV as well as associated intracardiac anomalies. Fetal cardiac MRI can be a useful adjunct in the identification of subaortic and retroesophageal anomalous courses of the LBCV prenatally.
Topics: Adult; Aneurysm; Aorta, Thoracic; Brachiocephalic Veins; Cardiovascular Abnormalities; Echocardiography; Esophagus; Female; Fetus; Heart Defects, Congenital; Humans; Magnetic Resonance Imaging; Mediastinum; Pregnancy; Pulmonary Atresia; Subclavian Artery; Tomography, X-Ray Computed; Ultrasonography, Prenatal; Vascular Malformations
PubMed: 30283087
DOI: 10.1038/s41598-018-33033-6 -
African Health Sciences Sep 2015Variations of vessels arising from the aortic arch are numerous. One of the common anatomical variations is the right subclavian artery originating as the last branch of... (Review)
Review
BACKGROUND
Variations of vessels arising from the aortic arch are numerous. One of the common anatomical variations is the right subclavian artery originating as the last branch of the aortic arch. This is a report of a case of an adult male cadaver with a retroesophageal right subclavian artery.
OBJECTIVE
To highlight the significance of a retroesophageal right subclavian artery, especially its clinical and surgical implications.
METHOD
Is a report of a case of an anomalous vessel found during routine student dissection of the chest region in a male cadaver.
RESULT
The retroesophageal subclavian artery was seen originating as the last branch from the postero-lateral aspect of the thoracic aorta at the vertebral level T4. The heart was normal with no other vascular variations seen in this region.
CONCLUSION
Anatomists and pathologists mainly encounter a retroesophageal right subclavian artery by chance and is usually described as asymptomatic, but several clinical conditions have been associated with its occurrence. This is a clear example of when knowledge of an anatomical variation is helpful in clinical practice.
Topics: Adult; Aorta, Thoracic; Esophagus; Humans; Male; Recurrent Laryngeal Nerve; Subclavian Artery
PubMed: 26957998
DOI: 10.4314/ahs.v15i3.44 -
Laryngoscope Investigative... Apr 2018In a retrospective study, the authors analyzed the surgical approach to the intrathoracic goiter to avoid sternotomy or thoracotomy.
OBJECTIVE
In a retrospective study, the authors analyzed the surgical approach to the intrathoracic goiter to avoid sternotomy or thoracotomy.
METHODS
We selected 70 intrathoracic cases of multinodular goiter out of 988 cases of thyroidectomy and compared them with cervical goiter cases. Surgical technique, results, and postsurgical complications were assessed.
RESULTS
The analyzed cases presented the retrosternal goiter (n = 53; 75.7%), the retrotracheal goiter (n = 9; 12.8%), and the retroesophageal goiter (n = 8; 11.4%). Complaining of chest pressure or discomfort was specific for intrathoracic cases (50%; 35 of 70). All goiters except one were removed via cervical incision. The surgeons used head reclination and isthmus dissection when removing sizable goiters. Mean weight of goiters was 180 g. The recurrent laryngeal nerve was more often temporarily damaged in intrathoracic cases in comparison with cervical cases (4.3% vs. 2.8%, = .04), but the difference in permanent injury was less significant ( = .09). The incidence of temporary hypoparathyroidism was significantly higher in intrathoracic cases ( = .01).
CONCLUSION
In cases of multinodular goiter the goiters of various extensions can be successfully removed via the cervical incision in most of the cases even if they occupy the retrosternal, retrotracheal, or retroesophageal position. The transthoracic approaches and sternotomy might be justified in malignant cases.
LEVEL OF EVIDENCE
4.
PubMed: 29721546
DOI: 10.1002/lio2.146 -
IDCases 2017Miliary tuberculosis results from the lymphohematogenous spread of and it is a rare form of this disease. The most affected places are the lymph nodes, pleura, and...
Miliary tuberculosis results from the lymphohematogenous spread of and it is a rare form of this disease. The most affected places are the lymph nodes, pleura, and osteoarticular system, but any organ can be involved. Currently the disease is still endemic in developing countries by its close association with poor living conditions and malnutrition. Other comorbidities, particularly infection by human immunodeficiency virus (HIV), diabetes mellitus, smoking and alcoholism are of great importance in the epidemiology of this disease. The authors describe the case of an adult man from Guinea-Bissau that has been residing in Portugal for the last few months, admitted with complaints of headache. He was submitted to a computerized tomography (CT) scan of the brain which showed multiple lesions. This led to further study and the diagnosis of a disseminated tuberculosis with cerebral, liver, prostate and retroesophageal involvement. He was started on anti-tuberculosis therapy, achieving good results.
PubMed: 28560175
DOI: 10.1016/j.idcr.2017.03.011 -
Frontiers in Pediatrics 2023This study aimed to report our experience in qualitative and quantitative evaluation of fetal complete vascular ring (CVR) using fetal cardiovascular magnetic resonance...
OBJECTIVE
This study aimed to report our experience in qualitative and quantitative evaluation of fetal complete vascular ring (CVR) using fetal cardiovascular magnetic resonance imaging (MRI) to improve prenatal diagnosis and make early postnatal management possible.
METHODS
A retrospective case-control study was performed on cases of CVR diagnosed using fetal cardiovascular MRI, and confirmed by postnatal imaging diagnosis. Associated abnormalities were recorded. The diameters of aortic arch isthmus (AoI) and ductus arteriosus (DA), and tracheal diameters in fetuses with tracheal compression were measured and compared with those of the control group.
RESULTS
All fetal CVR cases in this study included right aortic arch (RAA) with aberrant left subclavian artery (ALSA) and left DA ( = 93), double aortic arch (DAA) ( = 29), RAA with mirror-image branching and retroesophageal left ductus arteriosus (RLDA) ( = 8). Compared with the control group, the diameters of AoI in fetuses with DAA were decreased ( < 0.001), and the diameters of DA in fetuses with RAA with ALSA and left DA were increased ( < 0.001). The diameters of AoI and DA were positively correlated with gestational age (GA) in the normal control group (both < 0.001); The diameters of AoI and DA were also positively correlated with GA in RAA with ALSA and left DA subgroup (both < 0.001) and RAA with mirror-image branching and RLDA subgroup (AoI: = 0.003; DA: = 0.002); The diameters of DA were positively associated with GA in DAA subgroup ( < 0.001), however, there was no linear tendency between the diameters of AoI and GA in the DAA subgroup ( = 0.074). There were CVR fetuses with associated intracardiac malformation ( = 13), especially ventricular septal defect rather than complex heart disease, and extracardiac malformation ( = 14). Sixteen fetuses were shown the airway compression whose tracheal diameters were smaller than the normal ( < 0.001).
CONCLUSIONS
The altered diameters of AoI and DA can be detected and measured in CVR fetuses using fetal cardiovascular MRI. Fetal CVR can occur alone or with intracardiac and extracardiac malformation. Fetal CVR can be associated with prenatal airway compression.
PubMed: 37114010
DOI: 10.3389/fped.2023.1159130