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Interrupted aortic arch

Talha Niaz, Joseph T Poterucha, Jonathan N Johnson, Cecilia Craviari, Thomas Nienaber, Jared Palfreeman, Frank Cetta, Donald J Hagler
BACKGROUND: Bicuspid aortic valve (BAV) occurs both as an isolated cardiac lesion and in association with congenital heart defects (CHD). Their aim was to identify the incidence and morphology of BAV in patients with coexisting CHD and compare their disease progression to patients with isolated BAV. METHODS: The Mayo Clinic echocardiography database was retrospectively analyzed to identify pediatric and young adult patients (≤22 years) who were diagnosed with BAV from 1990 to 2015...
November 28, 2016: Congenital Heart Disease
Kate Hanneman, Beverley Newman, Frandics Chan
Congenital variants and anomalies of the aortic arch are important to recognize as they may be associated with vascular rings, congenital heart disease, and chromosomal abnormalities, and can have important implications for prognosis and management. The purpose of this article is to review cross-sectional imaging techniques used in the evaluation of the aortic arch, describe the embryology and anatomy of the aortic arch system, discuss aortic arch variants and anomalies, and review other malformations of the aortic arch, including interrupted aortic arch, hypoplastic aortic arch, and aortic coarctation...
November 18, 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
M Obadah Kattea, Osama A Smettei, Abdulrahman Kattea, Rami M Abazid
We present a case of 13-year-old female with Turner syndrome (TS), who presented with unexplained lower limbs swelling and ejection systolic murmur at the left second intercostal space. Suspicion of mild aortic coarctation was made by echocardiography. Computed tomography angiography (CTA) showed a complete interruption of the aortic arch (IAA) below the left subclavian artery with persistent left superior vena cava (PLSVC) and absent right SVC, defined as an isolated PLSVC. The patient underwent successful surgical correction after unsuccessful trial of transcatheter stent placement...
October 2016: Avicenna Journal of Medicine
Lisa S Foley, Katsuhiro Yamanaka, T Brett Reece
Neurologic injuries following aortic arch operations can be devastating, with stroke occurring in up to 12% of elective operations and significant cerebral dysfunction occurring in up to 25% of cases. The primary challenge unique to aortic arch operations involves interruption of direct perfusion of the brachiocephalic vessels during arch reconstruction. For this reason, neuroprotection is paramount. The 2 main modes of protection are (1) reducing metabolic demand through hypothermia and (2) limiting, or even eliminating, the ischemic period...
December 2016: Seminars in Cardiothoracic and Vascular Anesthesia
Patricia Y Chu, Jennifer S Li, Andrzej S Kosinski, Christoph P Hornik, Kevin D Hill
OBJECTIVE: To determine the birth prevalence of congenital heart defects (CHDs) across the spectrum of common defects in very/extremely premature infants and to compare mortality rates between premature infants with and without CHDs. STUDY DESIGN: The Kids' Inpatient Databases (2003-2012) were used to estimate the birth prevalence of CHDs (excluding patent ductus arteriosus) in very/extremely premature infants born between 25 and 32 weeks' gestational age. Birth prevalence was compared with term infants for a subset of "severe" defects expected to be near universally diagnosed in the neonatal period...
November 3, 2016: Journal of Pediatrics
Masih Tajdini, Akram Sardari, Seyed Khalil Forouzannia, Abdolvahab Baradaran, Seyed Mohammad Reza Hosseini, Seyed Ebrahim Kassaian
Interrupted aortic arch is a rare congenital abnormality with a high infancy mortality rate. The principal finding is loss of luminal continuity between the ascending and descending portions of the aorta. Because of the high mortality rate in infancy, interrupted aortic arch is very rare among adults. In this report, we describe the case of a 76-year-old woman with asymptomatic interrupted aortic arch, severe tricuspid regurgitation, and bicuspid aortic valve. To our knowledge, she is the oldest patient ever reported with this possibly unique combination of pathologic conditions...
October 2016: Texas Heart Institute Journal
Sherwin Abdoli, James M Tatum, Ashley L Fratello, Michael E Bowdish, Craig J Baker
The presentation and treatment of a patient with a type B interrupted aortic arch with an isolated left subclavian artery is described.
November 2016: Annals of Thoracic Surgery
T Kumanan, M Guruparan, K Gnanakanthan, U K Ratnayake
No abstract text is available yet for this article.
2016: Ceylon Medical Journal
Bui Quoc Thang, Tatsuya Furugaki, Motoo Osaka, Yutaka Watanabe, Shinya Kanemoto, Fuminaga Suetsugu, Yuji Hiramatsu
PURPOSE: There is less certainty regarding the best strategy for treating neonates with functional single ventricle (SV) and hypoplastic aortic arch. We have applied a modified extended aortic arch anastomosis (EAAA) and main pulmonary artery banding (PAB) as an initial palliation in neonates with transverse arch hypoplasia and assessed the mid-term outcomes. METHODS: In total, 10 neonates with functional SV and extensive hypoplasia or interruption of the arch underwent a modified EAAA (extended arch anastomosis with a subclavian flap) concomitant with main PAB through a thoracotomy without cardiopulmonary bypass...
October 11, 2016: Annals of Thoracic and Cardiovascular Surgery
Sijie Wu, Yifeng Yang, Shijun Hu, Tianli Zhao
Aortic arch reconstruction is the key to successfully repairing an interrupted aortic arch (IAA) with tubular hypoplasia of the aortic arch (THAA), especially in older children. We report a novel reconstruction technique involving aortapulmonary fusion that was used to treat THAA in a 9 year-old patient with IAA. In this procedure, the underside of the aortic arch and the upside of the main pulmonary artery were fused to reconstruct the aortic arch. The short-term outcome of the procedure has been promising...
September 22, 2016: Interactive Cardiovascular and Thoracic Surgery
Miguel Urencio, Ali Dodge-Khatami, Chris E Greenleaf, Giorgio Aru, Jorge D Salazar
For repair of interrupted aortic arch, unfavorable anatomy challenges a tension-free anastomosis. We describe a useful alternative surgical technique used in five neonates/infants, involving splitting the ascending aorta from the sinotubular junction to the arch origin, leftward and posterior "sliding" of the flap with anastomosis to the distal arch creating a native tissue bridge, and reconstruction with a patch. With wide interruption gaps between proximal and distal aortic portions, the ascending aortic slide is a safe and reproducible technique, providing a tension-free native tissue bridge with potential for growth, and a scaffold for patch augmentation in biventricular hearts, or for Norwood stage I in univentricular palliation...
September 2016: World Journal for Pediatric & Congenital Heart Surgery
Cecilia García, Teresa Álvarez, Coral Bravo, Ramón Pérez-Caballero, María Teresa Viadero, Francisco Gámez, Ricardo Pérez, Juan De León-Luis
A prenatal aortopulmonary window with an interrupted aortic arch was detected in a 22-week-old fetus. The 3-vessel and trachea view showed a communication between the ascending aorta and the pulmonary artery. Early postnatal surgery was successful. A PubMed-based search identified all cases of prenatal aortopulmonary windows between 2002 and 2015. Nine articles were identified. The average gestational age at diagnosis was 28 weeks (range, 22-33 weeks). The most frequent aortopulmonary window was type I (40%)...
October 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Michael O Kayatta, Edward P Chen
Hypothermic circulatory arrest is a critical component of aortic arch procedures, without which these operations could not be safely performed. Despite the use of hypothermia as a protective adjunct for organ preservation, aortic arch surgery remains complex and is associated with numerous complications despite years of surgical advancement. Deep hypothermic circulatory arrest affords the surgeon a safe period of time to perform the arch reconstruction, but this interruption of perfusion comes at a high clinical cost: stroke, paraplegia, and organ dysfunction are all potential-associated complications...
August 8, 2016: General Thoracic and Cardiovascular Surgery
Aditya K Kaza, Ravi R Thiagarajan
OBJECTIVES: The objectives of this review are to discuss the perioperative management of coarctation of the aorta, interrupted aortic arch, and the borderline left ventricle. METHODS: MEDLINE and PubMed. CONCLUSIONS: Successful management of systemic obstructive lesions involves a thorough evaluation of the anatomy and pathophysiology to determine the most effective management strategy.
August 2016: Pediatric Critical Care Medicine
Nobuyasu Kato, Masaaki Yamagishi, Takako Miyazaki, Yoshinobu Maeda, Satoshi Asada, Hisayuki Hongu, Eijiro Yamashita, Hitoshi Yaku
Right-sided interrupted aortic arch (IAA) is a rare cardiac anomaly. In general, the right bronchus sits higher than the left bronchus, so aortic arch reconstruction with a direct anastomosis has a risk of tracheal and bronchial obstruction. This report describes the successful definitive repair of a right-sided IAA in a 2.5-kg neonate by aortic arch reconstruction with a pulmonary autograft tube (PA tube). Postoperative three-dimensional multidetector computed tomography showed the reconstructed aortic arch without airway obstruction or aortic stenosis...
August 2016: Annals of Thoracic Surgery
Martin Kostolny, Ikenna Omeje
The surgical repair of Taussig-Bing anomaly and associated lesions has evolved over the years from palliative procedures to complete repairs-either in two stages or in one single stage. We present a video illustrating our preferred surgical option in the treatment of Taussig-Bing anomaly, in this case, with an associated type A interrupted aortic arch.
2016: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Tai Fuchigami, Masahiko Nishioka, Toru Akashige, Shotaro Higa, Kazuhiro Takahashi, Mami Nakayashiro, Taisuke Nabeshima, Arata Sashinami, Kenzo Sakurai, Kiyotaka Takefuta, Nobuhiro Nagata
OBJECTIVES: Bilateral pulmonary artery banding (bPAB) is utilized for some patients with a ventricular septal defect (VSD) and aortic coarctation (CoA) or interrupted aortic arch (IAA). We evaluated aortic valve (AoV) diameter and patient outcomes following bPAB. METHODS: Between August 2010 and September 2015, 10 consecutive patients with VSD and patent ductus arteriosus-dependent CoA or IAA underwent bPAB because of an AoV diameter of approximately <50% of the normal value (n = 6), severe subaortic stenosis and poor patient condition (n = 1, respectively), or low birthweight (n = 2)...
November 2016: Interactive Cardiovascular and Thoracic Surgery
Minoo N Kavarana
The management of children born with trisomy 18 is controversial, and both providers and parents often have differing opinions. Many parents choose to terminate the pregnancy while others go forward, making decisions based on their beliefs, understanding, and physician recommendations. Physicians are similarly divided regarding treatment of these children, as some feel that aggressive treatments are futile while others defer to the parents' wishes.Interrupted aortic arch with ventricular septal defect in children with trisomy 18 presents an ethical dilemma that highlights the kinds of controversies in medical decision making facing physicians on a daily basis...
June 2016: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
Angira Patel, John M Costello, Carl L Backer, Sara K Pasquali, Kevin D Hill, Amelia S Wallace, Jeffrey P Jacobs, Marshall L Jacobs
BACKGROUND: Among patients with congenital heart disease (CHD), the coexistence of noncardiac congenital anatomic abnormalities (NC), genetic abnormalities (GA), and syndromes (S) may influence therapeutic strategies and outcomes. The appreciated prevalence of these abnormalities has risen because increased screening and improved diagnostic precision enable identification of these comorbidities in a larger fraction of neonates with CHD. We examined the contemporary prevalence and distribution of NC/GA/S across diagnostic groups among neonates undergoing cardiac operations using a large nationally representative clinical registry...
November 2016: Annals of Thoracic Surgery
B N Kozlov, D S Panfilov, V V Saushkin, M S Kuznetsov, G G Nasrashvili, V M Shipulin
AIM: To evaluate surgical results in adults with aortic arch interruption. MATERIAL AND METHODS: Seven patients with aortic arch interruption were operated. Two of them (28.6%) underwent aortic arch repair using allograft, 4 (57.21%) - distal arch and proximal descending aortic replacement, 1 (14.3%) - supra-coronary ascending aortic, aortic arch and proximal descending aortic replacement. All operations were performed under moderate hypothermia (25 °С), circulatory arrest with unilateral cerabral perfusion 8-10 ml/kg/min via innominate artery and pressure 69...
2016: Khirurgiia
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