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Zhang S, Wang J, Han J, Wang L, Wang L, Xiong X, Wu Q. Prenatal ultrasound findings, genetic testing, and literature review of Isolated left subclavian artery. Echocardiography 2023. [PMID: 37139852 DOI: 10.1111/echo.15577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/27/2023] [Accepted: 04/11/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND The occurrence of Isolated left subclavian artery (ILSA) is relatively rare, ILSA is caused by the persistence of the dorsal segment of the sixth left arch, with regression of the fourth arch artery and interruption of the left dorsal aorta at the distal end of the seventh intersegmental artery on the left side during embryonic development. The left subclavian artery is connected to the pulmonary artery through an arterial duct, which can be closed or unobstructed. This abnormality can lead to congenital subclavian steal syndrome and vertebrobasilar artery insufficiency. CASE PRESENTATION We reported three fetuses with ILSA and intracardiac malformation. Among them, one case was suspected to be diagnosed with ILSA by echocardiography, while the other two cases were not diagnosed, but were accidentally discovered during autopsy. We have also conducted a literature review of its prenatal screening, diagnosis, management, and outcomes. Our three cases were tested by WES-Trio (whole exome sequencing). Worldwide, the ILSA cases reported in English literature have not been detected by WES. And likely pathogenic results were found in our two cases. Although it could not explain the intracardiac malformation we found, it will help to explore the etiology in the future. CONCLUSIONS Prenatal echocardiography detection and diagnosis of ILSA is a new challenge, which has different effects on the prognosis of the fetus. When finding intracardiac malformation with right aortic arch, we need to perform an unconventional view of ultrasound scanning and combine with CDFI to find the origin of the left subclavian artery. Although we cannot find the cause of the disease temporarily, but our genetic results can help prenatal genetic counseling.
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Affiliation(s)
- Simin Zhang
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, P.R. China
- Beijing Maternal and Child Health Care Hospital, Beijing, P.R. China
| | - Jingjing Wang
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, P.R. China
- Beijing Maternal and Child Health Care Hospital, Beijing, P.R. China
| | - Jijing Han
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, P.R. China
- Beijing Maternal and Child Health Care Hospital, Beijing, P.R. China
| | - Li Wang
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, P.R. China
- Beijing Maternal and Child Health Care Hospital, Beijing, P.R. China
| | - Limei Wang
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, P.R. China
- Beijing Maternal and Child Health Care Hospital, Beijing, P.R. China
| | - Xiaowei Xiong
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, P.R. China
- Beijing Maternal and Child Health Care Hospital, Beijing, P.R. China
| | - Qingqing Wu
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, P.R. China
- Beijing Maternal and Child Health Care Hospital, Beijing, P.R. China
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Soynov IA, Kulyabin YY, Arkhipov AN, Ivanzov SM, Galstyan MG, Voitov AV. Surgical Repair of Anomalous Origin of the Left Subclavian Artery From the Pulmonary Artery Using a Supraclavicular Approach. World J Pediatr Congenit Heart Surg 2023; 14:392-394. [PMID: 36811619 DOI: 10.1177/21501351221149901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Anomalous origin of the left subclavian artery from the pulmonary artery is a rare congenital cardiac malformation. We describe a case of anomalous origin of the left subclavian artery from the pulmonary artery in a patient who presented with symptoms of vertebrobasilar insufficiency and underwent reimplantation of the left subclavian artery into the left common carotid artery from the supraclavicular approach.
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Affiliation(s)
- Ilya A Soynov
- Department of Congenital Heart Disease, National Medical Research Center, Novosibirsk, Russian Federation
| | - Yuriy Y Kulyabin
- Department of Congenital Heart Disease, National Medical Research Center, Novosibirsk, Russian Federation
| | - Alexey N Arkhipov
- Department of Congenital Heart Disease, National Medical Research Center, Novosibirsk, Russian Federation
| | - Sergey M Ivanzov
- Department of Congenital Heart Disease, National Medical Research Center, Novosibirsk, Russian Federation
| | - Meline G Galstyan
- Department of Congenital Heart Disease, National Medical Research Center, Novosibirsk, Russian Federation
| | - Alexey V Voitov
- Department of Congenital Heart Disease, National Medical Research Center, Novosibirsk, Russian Federation
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Cai J, Xie C, Wang X. Subclavian steal syndrome associated with right aortic arch: A case report. Front Surg 2023; 9:1063224. [PMID: 36684375 PMCID: PMC9852614 DOI: 10.3389/fsurg.2022.1063224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/21/2022] [Indexed: 01/07/2023] Open
Abstract
The right aortic arch (RAA) is a rare congenital vascular variant disease. We reported a case of subclavian steal syndrome associated with RAA. The primary clinical symptoms were vertigo and ischemic symptoms of the left upper extremity. We diagnosed the condition using aortic computed tomography angiography and digital subtraction angiography. The patient underwent carotid-subclavian bypass surgery.
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Affiliation(s)
- Jing Cai
- Department of General Practice, Xiangya Hospital, Central South University, Changsha, China
| | - Chao Xie
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xianwei Wang
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, China,Correspondence: Xianwei Wang Email
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Hao XY, Zhang Y, Zhao Y, Liu X, Gu X, Han JC, He YH. Prenatal diagnosis of isolation of aortic brachiocephalic artery. Acta Radiol 2021; 63:1712-1720. [PMID: 34859686 DOI: 10.1177/02841851211058278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Isolated aortic brachiocephalic artery (IABA) is a rare congenital aortic arch anomaly. It is difficult to diagnose IABA prenatally and the prevalence in the prenatal population is unknown. PURPOSE To evaluate the echocardiographic characteristics and associations in fetuses with IABA. MATERIAL AND METHODS We retrospectively analyzed all cases of prenatal diagnosis of IABA from January 2012 to November 2020 and reviewed the follow-up results. Copy Number Variation Sequencing (CNV-Seq) was performed using the biological specimens of the of the fetuses and family members. RESULTS Ten cases (10/45652, 0.022%) of IABA were identified in our center. The prevalence of the cases with isolated left subclavian artery (ILSCA) in the right aortic arch (RAA) population was 0.98% (6/613). The ILSCA was the most common isolated arch branch. All the isolated branches were on the opposite side of aortic arch in all the cases. The "ice stick" sign in the coronal section could be seen in most cases of IABA. Of the 10 cases, 8 (8/10, 80%) were associated with tetralogy of Fallot (TOF). Two cases of IABA were combined with 22q11.2 deletion syndrome. CONCLUSION IABA is a rare aortic anomaly. ILSCA was the most common isolated arch branch and TOF was the most common associated intra-cardiac anomaly. The "ice stick" sign in the coronal section could indicate a diagnosis of the IABA.
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Affiliation(s)
- Xiao-yan Hao
- Beijing Key Laboratory of Maternal-Fetal Medicine and Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, PR China
| | - Ye Zhang
- Beijing Key Laboratory of Maternal-Fetal Medicine and Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, PR China
| | - Ying Zhao
- Beijing Key Laboratory of Maternal-Fetal Medicine and Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, PR China
| | - Xiaowei Liu
- Beijing Key Laboratory of Maternal-Fetal Medicine and Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, PR China
| | - Xiaoyan Gu
- Beijing Key Laboratory of Maternal-Fetal Medicine and Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, PR China
| | - Jian-cheng Han
- Beijing Key Laboratory of Maternal-Fetal Medicine and Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, PR China
| | - Yi-hua He
- Beijing Key Laboratory of Maternal-Fetal Medicine and Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, PR China
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Wen Y, Xiang G, Xiong C, Yang Y, Zhang J. Isolated left subclavian artery with right aortic arch and bilateral ductus arteriosus: a challenging fetal diagnosis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2021; 57:500-501. [PMID: 32250490 DOI: 10.1002/uog.22039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/20/2020] [Accepted: 03/27/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Y Wen
- Department of Ultrasound, The Fifth People's Hospital of Chengdu, Chengdu, Sichuan Province, China
| | - G Xiang
- Department of Ultrasound, The Fifth People's Hospital of Chengdu, Chengdu, Sichuan Province, China
| | - C Xiong
- Department of Ultrasound, The Fifth People's Hospital of Chengdu, Chengdu, Sichuan Province, China
| | - Y Yang
- Department of Radiology, The Women and Children's Hospital of Chengdu, Chengdu, Sichuan Province, China
| | - J Zhang
- Department of Ultrasound, The Fifth People's Hospital of Chengdu, Chengdu, Sichuan Province, China
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6
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Left subclavian artery originating from left pulmonary artery in DiGeorge syndrome. TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2021; 28:691-694. [PMID: 33403146 PMCID: PMC7759048 DOI: 10.5606/tgkdc.dergisi.2020.19613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/03/2020] [Indexed: 11/21/2022]
Abstract
Left subclavian artery originating from the left pulmonary artery is a rare aortic arch anomaly. Herein, we, for the first time in Turkey, present a case of left subclavian artery originating from the left pulmonary artery via ductus arteriosus in DiGeorge syndrome and causing subclavian steal syndrome.
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7
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Prenatal Ultrasonic Diagnosis and Prognostic Analysis of Isolated Left Subclavian Artery (ILSCA) and Left Brachiocephalic Trunk (ILBCT) Malformation. Pediatr Cardiol 2018; 39:1650-1655. [PMID: 30167747 DOI: 10.1007/s00246-018-1945-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 07/28/2018] [Indexed: 10/28/2022]
Abstract
The purpose of the study was to explore the prognosis, as well as antenatal ultrasonic features of isolated left subclavian artery (ILSCA) and isolated left brachiocephalic trunk (ILBCT) malformations, in order to improve prognosis and provide guidance for prenatal diagnosis. The origin and routing of cephalic and cervical vessels were observed in patients diagnosed with right aortic arch or right arterial duct arch in our hospital from March 2015 to March 2017, and the spectrum features related to ILSCA and ILBCT were analyzed. Fetuses diagnosed as ILSCA, or, and ILBCT were followed up for 3 months after birth. At the same time, a literature review was carried out for ILBCT and ILSCA in Pubmed. In our study, two cases with ILSCA and ILBCT were both diagnosed prenatally. They are not accompanied by other congenital malformations or chromosome abnormalities. No abnormality was found during postnatal follow-up except that left radial pulsation was weakened and blood pressure of the left upper limb decreased in baby with ILSCA. In baby with ILBCT, in addition to these abnormal changes, the left common carotid artery pulse disappearance too. In pubmed, three of 12 ILSCA or ILBCT did not have other congenital malformation or chromosome abnormalities. They were not diagnosed until the age of 3, 10, and 47 because of school exams or atypical symptoms, such as headaches, chest pain. Symptom of ILBCT or ILSCA without other abnormality is silent, and therefore they cannot be diagnosed timely after birth prenatal diagnosis is necessary for they can be treated in time.
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8
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Catton KG, Setty SP. Anomalous left subclavian artery from the pulmonary artery in a neonate. Asian Cardiovasc Thorac Ann 2018; 26:476-478. [PMID: 29860892 DOI: 10.1177/0218492318780798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The presence of an isolated left subclavian artery arising from the pulmonary artery in a patient with d-transposition of the great arteries is exceedingly rare. Prior to undertaking repair of this congenital cardiac anomaly, identification of an isolated left subclavian artery originating from the pulmonary artery is imperative in order to plan the appropriate intervention to prevent the development of subclavian artery steal or vertebrobasilar insufficiency. We describe the case of a 5 day-old girl in whom an isolated left subclavian artery arising from the pulmonary artery was detected after surgical entry for repair of transposition of the great arteries.
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Affiliation(s)
- Kirsti G Catton
- Miller Children's and Women's Hospital, Memorial Heart and Vascular Institute, Long Beach, CA, USA
| | - Shaun P Setty
- Miller Children's and Women's Hospital, Memorial Heart and Vascular Institute, Long Beach, CA, USA
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9
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Şuteu CC, Togănel R, Benedek T. Three Rare Anomalies of the Large Vessels in an Infant with Tetralogy of Fallot. J Card Surg 2016; 31:461-3. [PMID: 27246554 DOI: 10.1111/jocs.12770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Isolated left subclavian artery (LSA) from the pulmonary artery (PA) is a very rare vascular anomaly. We report a case of abnormal origin of the LSA from the PA via a very large ductus arteriosus (DA) in association with a rare communication between the left common carotid artery (LCCA) and the LSA in a patient with tetralogy of Fallot. doi: 10.1111/jocs.12770 (J Card Surg 2016;31:461-463).
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Affiliation(s)
- Carmen C Şuteu
- Department of Cardiology, University of Medicine and Pharmacy Tîrgu Mureş, Romania
| | - Rodica Togănel
- Department of Cardiology, University of Medicine and Pharmacy Tîrgu Mureş, Romania
| | - Theodora Benedek
- Department of Cardiology, University of Medicine and Pharmacy Tîrgu Mureş, Romania
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10
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McVadon D, Shakti D, Knudson J, Dodge-Khatami A, Batlivala SP. Isolated Left Subclavian Artery From the Pulmonary Artery Masked by Pulmonary Hypertension. World J Pediatr Congenit Heart Surg 2016; 7:765-768. [PMID: 26884449 DOI: 10.1177/2150135115609536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 09/05/2015] [Indexed: 11/15/2022]
Abstract
Isolated subclavian artery arising from the pulmonary artery is exceedingly rare. Most cases are associated with other forms of congenital heart disease and typically present with subclavian or pulmonary steal syndromes. We report the case of a patient with pulmonary hypertension which masked the isolated subclavian artery, allowing it to masquerade as another common congenital heart lesion.
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Affiliation(s)
- Deani McVadon
- School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Divya Shakti
- School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.,Division of Pediatric Cardiology, Blair E. Batson Hospital for Children, Jackson, MS, USA
| | - Jarrod Knudson
- School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.,Division of Pediatric Cardiology, Blair E. Batson Hospital for Children, Jackson, MS, USA
| | - Ali Dodge-Khatami
- School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.,Section of Pediatric and Congenital Heart Surgery, Blair E. Batson Hospital for Children, Jackson, MS, USA
| | - Sarosh P Batlivala
- School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA .,Division of Pediatric Cardiology, Blair E. Batson Hospital for Children, Jackson, MS, USA
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Lee JS, Park JY, Ko SM, Seo DM. Isolation of the Left Subclavian Artery with Right Aortic Arch in Association with Bilateral Ductus Arteriosus and Ventricular Septal Defect. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2015; 48:415-8. [PMID: 26665110 PMCID: PMC4672978 DOI: 10.5090/kjtcs.2015.48.6.415] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 11/07/2014] [Accepted: 11/08/2014] [Indexed: 11/16/2022]
Abstract
Right aortic arch with isolation of the left subclavian artery is a rare anomaly. The incidence of bilateral ductus arteriosus is sporadic, and a right aortic arch with isolation of the left subclavian artery in association with bilateral ductus arteriosus is therefore extremely rare. Since the symptoms and signs of isolation of the left subclavian artery can include the absence or underdevelopment of the left arm, subclavian steal syndrome, or pulmonary artery steal syndrome, the proper therapeutic approach is controversial. We report a case in which surgical reconstruction was used to treat isolation of the left subclavian artery with right aortic arch in association with bilateral ductus arteriosus and a ventricular septal defect.
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Affiliation(s)
- Ji Seong Lee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine
| | - Ji Young Park
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine
| | - Seong Min Ko
- Department of Radiology and Research Institute of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine
| | - Dong-Man Seo
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine
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