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aberrant right subclavian

Yuki Tanaka, Tadashi Kitamura, Yusuke Irisawa, Kagami Miyaji
We present a case of Kommerell's diverticulum with the aberrant left subclavian artery and a right-sided aortic arch in a 70-year-old male patient who was treated with total arch replacement using the Gelweave Lupiae graft. The Lupiae graft fitted well to total arch replacement for this pathology because the structure was consistent with the anatomical features.
March 12, 2018: Interactive Cardiovascular and Thoracic Surgery
Tresson Philippe, Ballabio Fabrizia, Manceau Gilles, Adam Nicolas, Lawton James, Davaine Jean-Michel, Koskas Fabien
Pseudoaneurysm due to a swallowed fish bone rarely involves subclavian arteries. A 46-year-old male with non-aberrant right subclavian artery presented pseudoaneurysm and brachial plexus septic necrosis. Open surgery with sternotomy and right transverse supraclavicular cervicotomy was done in emergency to achieve revascularization by in situ cryopreserved arterial allograft. Infection severity led to septic allograft rupture that necessitated ligation without new arterial reconstruction. During follow-up patient remained alive 8 months after surgery...
March 5, 2018: Annals of Vascular Surgery
Muhammad Yaman Adi, William Adams
Anomalous origin of the right vertebral artery from the right common carotid artery (VA-CCA) with an aberrant right subclavian artery (ARSCA) is an uncommon anatomical variant. We present a series of images from a case in which this was identified on angiography for the management of a right posterior inferior cerebellar artery (PICA) aneurysm. This combination has not been previously described in the literature. The embryological mechanism of this variation, the incidence of these individual findings and the clinical implications will be discussed...
February 28, 2018: British Journal of Neurosurgery
Akira Tempaku, Terumasa Kuroiwa, Akimasa Nishio
Purpose Right-sided aortic arch is a rare vessel anomaly with an incidence of 0.1% worldwide. Supra-aortic branches form a mirror image of the left-sided aortic arch or an aberrant left subclavian artery associated with Kommerell diverticulum. Most patients are diagnosed by a difference in blood pressure in each upper extremity or by the presence of left subclavian steal syndrome in their younger age. The diagnosis of onset of ischemic stroke in middle age is rare. Methods We present the case of a female patient who presented with an ischemic stroke in the left posterior circulation area...
January 1, 2018: Interventional Neuroradiology
Nikolaos Lazaridis, Maria Piagkou, Marios Loukas, Evangelia-Theophano Piperaki, Trifon Totlis, Georgios Noussios, Konstantinos Natsis
Several congenital anomalies regarding the right (RVA) and left (LVA) vertebral artery have been described. The current paper aims to perform a systematic literature review of the variable vertebral artery (VA) origin from the aortic arch (AOA) and its branches. The incidence of these variants and the ensuing AOA branching pattern are highlighted. Atypical origin cases were found more commonly unilaterally, while LVA presented the majority of the aberrancies. The LVA emersion from the AOA (3.6%) and the RVA from the right common carotid artery (RCCA) (0...
February 19, 2018: Surgical and Radiologic Anatomy: SRA
Pınar Beyaz, Nadia Khan, Gerasimos Baltsavias
Here we report, for the first time, a combination of five-vessel aortic arch, anomalous origin of the right vertebral artery (VA) from the common carotid artery (CCA), an aberrant right subclavian artery (SCA), and bilateral symmetrical segmental agenesis of VAs.In this case report, we present a patient with moyamoya syndrome (MMS) and Down syndrome (DS) who has bilateral symmetrical segmental agenesis of VAs, left VA originating from aortic arch and anomalous origin of right VA arising from CCA in combination with an aberrant right SCA...
February 14, 2018: Journal of Neurointerventional Surgery
Funda Oztunc, Sezen Ugan Atik, Reyhan Dedeoglu, Mehmet Aytac Yuksel, Rıza Madazlı
Aortic arch anomalies refer to congenital malformations of position or branching pattern of the aortic arch. To-date, only a few small studies have documented prenatal detection of aortic arch anomalies. In this article, we share our experience in detecting aortic arch anomalies. Foetal echocardiograms, clinic and genetic histories of 33 patients who had been diagnosed with aortic arch anomaly from 2007 to 2015 were reviewed. In 15 patients, right aortic arch with mirror image branching; in 13 patients, right aortic arch with left ductus arteriosus and aberrant left subclavian artery; in three patients, left aortic arch with aberrant right subclavian artery; in one patient bilateral ductus and right aortic arch with aberrant left subclavian artery and in one patient double aortic arch were detected...
February 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Akihiko Okamura, Masayuki Watanabe, Masami Yuda, Yoshiaki Shoji, Kotaro Yamashita, Masaru Hayami, Yu Imamura, Shinji Mine
BACKGROUND: Esophageal cancer frequently metastasizes to lymph nodes along the recurrent laryngeal nerve (RLN),1 therefore it is essential to dissect RLN nodes for curative esophagectomy.2 Right-sided aortic arch (RAA), a rare congenital anomaly, occurs in approximately 0.1% of adults.3 Because RAA forms a vascular ring encircling both the esophagus and the trachea at the cervicothoracic junction, its surgical anatomy is difficult to understand; hence, thoracoscopic dissection of RLN nodes is technically challenging...
February 6, 2018: Annals of Surgical Oncology
Keito Suzuki, Akira Sezai, Satoshi Unosawa, Masashi Tanaka
No abstract text is available yet for this article.
January 31, 2018: Journal of Cardiac Surgery
Pınar Beyaz, Nadia Khan, Gerasimos Baltsavias
Here we report, for the first time, a combination of five-vessel aortic arch, anomalous origin of the right vertebral artery (VA) from the common carotid artery (CCA), an aberrant right subclavian artery (SCA), and bilateral symmetrical segmental agenesis of VAs.In this case report, we present a patient with moyamoya syndrome (MMS) and Down syndrome (DS) who has bilateral symmetrical segmental agenesis of VAs, left VA originating from aortic arch and anomalous origin of right VA arising from CCA in combination with an aberrant right SCA...
January 23, 2018: BMJ Case Reports
Tariq Almerey, Ricardo Paz-Fumagalli, Houssam Farres, Warner A Oldenburg, Albert G Hakaim
Aneurysms of the internal mammary artery are extremely rare. Immediate treatment is necessary because of the high risk of rupture that can be life-threatening. Here we describe a case of idiopathic internal mammary artery aneurysm in a 54-year-old woman in the setting of aberrant right subclavian artery. The aneurysm was successfully treated with coil embolization without complications.
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
David Drullinsky, Heather Gill, Jason P Bayne, Jean-Francois Morin, Daniel Obrand
Aberrant right subclavian artery is the most common congenital malformation of the aortic arch (0.4%-2.0%). Aneurysms of aberrant subclavian arteries are extremely rare. This results in little experience with their treatment. We describe a case of a patient who presented to the emergency department with a dissection of an aberrant right subclavian artery that later progressed to rupture. Besides hemodynamic instability, this caused an acute superior vena cava syndrome, making airway control difficult. In the operating room, we obtained proximal control through thoracic endovascular aortic repair; median sternotomy was performed for distal control and evacuation of massive hemomediastinum...
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
Yasuhiro Hirano, Noboru Inamura, Yukiko Kawazu, Hisaaki Aoki, Futoshi Kayatani, Shigemitsu Iwai, Hiroaki Kawata
BACKGROUND: At our institution, we perform bilateral pulmonary artery banding (BPAB) as the first-stage palliation for interrupted aortic arch (IAA) with low birth weight or severe subaortic stenosis (SAS). The present study aimed to identify factors that may influence the decision regarding the type of second-stage operation, that is, univentricular palliation or biventricular repair, in these patients. METHODS: Cardiac catheterization and angiographic data of nine patients with IAA who underwent initial BPAB and subsequent univentricular or biventricular repair were retrospectively analyzed...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
Trisha V Vigneswaran, Eva Kapravelou, Aaron J Bell, Andrew Nyman, Kuberan Pushparajah, John M Simpson, Andrew Durward, Vita Zidere
A right aortic arch (RAA) with a left arterial duct (LAD) together encircle the trachea and have the potential to cause tracheobronchial compression and published guidelines recommend bronchoscopy in symptomatic patients. The aim of the study was to describe the incidence of tracheal compression in a cohort of prenatally diagnosed RAA and LAD. Retrospective review of clinical course and imaging of prenatal cases of RAA and LAD assessed with flexible bronchoscopy over an 11-year period. 34 cases of prenatally diagnosed RAA with LAD underwent bronchoscopy at median age of 9 months (range 0...
January 6, 2018: Pediatric Cardiology
Xiaoning Sun, Hongqiang Zhang, Kai Zhu, Chunsheng Wang
BACKGROUND: Kommerell's diverticulum is a complex congenital malformation of aorta. Three-dimensional (3D) printing is an innovative manufacturing process that allows computer-assisted conversion of 3D imaging data into physical "printouts." The aim of this study was to explore the feasibility and impact of using patient-specific 3D-printed cardiac prototypes derived from computed tomography data on surgical decision-making and preoperative planning for Kommerell's diverticulum. METHODS: From April to August 2017, five patients with Kommerell's diverticulum were diagnosed and chosen for study...
December 26, 2017: International Journal of Cardiology
Aisling M O'Malley, Walid H El Kininy, Helina Debebe, Azreena B Burukan, Shane W Davy
AIM: The aim of this study is to investigate the incidence of variation in the branching pattern of aortic arch (AA) vessels in an Irish population. METHOD: A cadaveric study of 24 subjects was conducted. The vessels of the AA were identified, their branching patterns were noted and photographed and the following measurements were recorded: the angle of the AA to the coronal plane, the distance from the midline to the brachiocephalic trunk (BCT); the left common carotid artery (LCC) ; the left subclavian artery (LSC), the distance between the BCT and the right subclavian artery (RSC); the RSC and the right vertebral artery (RVA), and between the LSC and left vertebral artery (LVA)...
December 29, 2017: Irish Journal of Medical Science
Gladys Mayte Nogueiras, Rafael Vicens-Rodriguez, Enrique Silva-Ayala, Orlando Lopez de Victoria, Francisco Diaz-Lozada
A Kommerell's diverticulum is a rare embryologic defect of the aortic arch. The majority of the patients having this defect present with dysphagia, dyspnea, and syncope, or a combination of any 2 or all 3. For symptomatic cases, surgical correction is always the standard of care. However, it is somewhat controversial what to do about asymptomatic cases. While surgery is almost always recommended, should asymptomatic patients undergo this procedure or not? Is it worth performing thoracic surgery for an anomaly whose nature is not really understood? In this case report, we describe a Kommerell diverticulum discovered incidentally in a 70-year old asymptomatic male...
December 2017: Puerto Rico Health Sciences Journal
Arsalan Rafiq, Surendra Chutani, Nassim R Krim
Arteria lusoria is the most common anomaly of the aortic arch with an incidence of 0.5%-2.5%. It is mostly diagnosed incidentally while performing imaging for evaluation of other unrelated medical conditions. The aberrant right subclavian artery arises beyond the origin of the left subclavian artery from the aortic arch. This results in a complex right-subclavian-aortic anatomy which leads to difficulty in transradial coronary angiography. This can lead to prolonged procedure time and increased use of catheters by unaware interventionists...
December 8, 2017: Catheterization and Cardiovascular Interventions
Catherine Lavallée, Christian Ayoub, Asmaa Mansour, Jean Lambert, Jean-Sébastien Lebon, Manoj M Lalu, André Denault
PURPOSE: The primary objective of this study was to define the ultrasound-derived anatomy of the axillary/subclavian vessels. As a secondary objective, we evaluated the relationship between the vascular anatomy and demographic, anthropometric, and hemodynamic data of patients. METHODS: This observational anatomical study used bedside ultrasound with 150 cardiac surgical patients in the operating room. Bilateral axillary and subclavian anatomy was determined using a high-frequency ultrasound probe with fixed reference points...
December 5, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Xiaoyang Hua, Henry Diggelmann, Vishram Jalukar, Joseph W Turek, Nitin A Pagedar
BACKGROUND: Left nonrecurrent laryngeal nerve (LNRLN) is an extremely rare anatomic variant. The development of such anatomic variation requires the regression of both the fourth (aortic arch) and sixth (ductus arteriosus, DA) arches on the left side. Preoperative prediction of this variant is difficult but might reduce risk of nerve injury. METHODS: A 34-year-old female was indicated for thyroidectomy for a 2.4 cm follicular neoplasm and Graves' disease. Due to a positive medical history of 22q11...
February 2018: Annals of Otology, Rhinology, and Laryngology
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