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Soh JK, Alcock R, Chen W. Incidental finding of double aortic arch and tract from noncoronary sinus to left atrium: A case report. Radiol Case Rep 2024; 19:254-259. [PMID: 38028280 PMCID: PMC10630763 DOI: 10.1016/j.radcr.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
The double aortic arch with vascular ring is a rare but documented aortic arch variant, traditionally presenting with difficulty swallowing or breathing due to extrinsic compression. Tracts from the noncoronary sinus to left atrium are very rare, with limited case reports to compare against. We report an incidental finding of double aortic arch in an elderly woman who underwent a cerebral angiogram for symptoms of a right-sided stroke, with a further anomaly identified on subsequent CT gated aortogram of a possible tract between the non-coronary sinus and left atrium. It is worth noting that the aortic arch abnormality was missed on previous plain radiographs, which can happen even among experienced radiologists. This case illustrates the need for a thorough, systematic approach to interpreting chest radiographs to avoid missing mediastinal lesions, such as aortic abnormalities.
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Affiliation(s)
- Jin Kai Soh
- Department of Radiology, Salisbury District Hospital, Salisbury NHS Foundation Trust, Odstock Road, Salisbury SP2 8BJ, United Kingdom
| | - Robin Alcock
- Department of Radiology, Salisbury District Hospital, Salisbury NHS Foundation Trust, Odstock Road, Salisbury SP2 8BJ, United Kingdom
| | - Weiyu Chen
- Department of Radiology, Salisbury District Hospital, Salisbury NHS Foundation Trust, Odstock Road, Salisbury SP2 8BJ, United Kingdom
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Ding P, Chen F, Qi J, Peng W, Wu K, Ding J, Ye M, Hu L, Xu J, Mo X. Perioperative Brain Injury in Children with Aortic Arch Anomalies: A Retrospective Study of Risk Factors and Outcomes. Pediatr Cardiol 2023:10.1007/s00246-023-03246-2. [PMID: 37561170 DOI: 10.1007/s00246-023-03246-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/20/2023] [Indexed: 08/11/2023]
Abstract
Complex pediatric cardiac disease is associated with brain impairment and neurodevelopmental disorders, particularly in patients requiring cardiac surgery for aortic arch anomalies. This study examines the incidence, risk factors, and outcomes of perioperative brain injury in children undergoing aortic arch repair who had aortic arch anomalies. A total of 145 children with aortic arch anomalies in our center undergoing aortic arch repair between January 2014 and December 2022 were enrolled. There were 129 (89.0%) with coarctation of the aorta (COA) and 16 (9.7%) with interrupted aortic arch (IAA). Risk factor analysis of brain injuries was done using perioperative imaging and included symptoms of hemorrhagic stroke, arterial ischemic stroke, white matter injury, cerebral sinus venous thrombosis, and other pathologies. Preoperatively, 50/145 (34.5%) patients had brain injuries. Multivariate analysis showed that an increased risk of hemorrhagic stroke was associated with newborns (odds ratio [OR], 2.09 [95% CI 0.08-3.50]), isolated COA (OR, 3.69 [95% CI 1.23-7.07]), mechanical ventilation (MV) ([OR, 2.56 [95% CI 1.25-4.03]), and sepsis (OR, 1.73 [95% CI 0.46-3.22]). Newborns ([OR, 1.91 [95% Cl 0.58-3.29]) and weight-for-age z score ([OR, -0.45 [95% CI -0.88 to -0.1]) were associated with an increased risk of white matter injury. New postoperative brain injuries were present in 12.9% of the patients (16/124). Deep hypothermic circulatory arrest (DHCA) was associated with new postoperative brain injuries compared with deep hypothermic low-flow (DHLF) plus antegrade cerebral perfusion (ACP) (([OR, 2.67 [95% CI, 0.58-5.75])). Isolated COA was almost associated with new postoperative brain injuries (OR, 1.13 [95% CI, -0.04 to 2.32]). Children diagnosed with isolated COA appeared to have a higher risk of perioperative brain injury, but the underlying mechanisms are still unclear. We focused on the intrinsic mechanism by which changes in hemodynamics caused by COA result in perioperative brain injury. Further research will be needed to optimize the personalized treatment and cerebral perfusion techniques for complex pediatric cardiac surgery.
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Affiliation(s)
- Peicheng Ding
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, No. 8 Jiangdongnan Road, JIanyeDistrict, Nanjing, 210008, China
| | - Feng Chen
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, No. 8 Jiangdongnan Road, JIanyeDistrict, Nanjing, 210008, China
| | - Jirong Qi
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, No. 8 Jiangdongnan Road, JIanyeDistrict, Nanjing, 210008, China
| | - Wei Peng
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, No. 8 Jiangdongnan Road, JIanyeDistrict, Nanjing, 210008, China
| | - Kaihong Wu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, No. 8 Jiangdongnan Road, JIanyeDistrict, Nanjing, 210008, China
| | - Jie Ding
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, No. 8 Jiangdongnan Road, JIanyeDistrict, Nanjing, 210008, China
| | - Mingtang Ye
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, No. 8 Jiangdongnan Road, JIanyeDistrict, Nanjing, 210008, China
| | - Liang Hu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, No. 8 Jiangdongnan Road, JIanyeDistrict, Nanjing, 210008, China
| | - Jiali Xu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, No. 8 Jiangdongnan Road, JIanyeDistrict, Nanjing, 210008, China
| | - Xuming Mo
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, No. 8 Jiangdongnan Road, JIanyeDistrict, Nanjing, 210008, China.
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Srnková P, Olejník P. The use of 3D-virtual anatomical model in a child with dysphagia lusoria. Int J Cardiovasc Imaging 2023:10.1007/s10554-023-02833-x. [PMID: 36997836 DOI: 10.1007/s10554-023-02833-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 03/07/2023] [Indexed: 04/01/2023]
Affiliation(s)
- Patrícia Srnková
- Department of Pediatric Cardiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
- Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases, Children's Cardiac Center, Bratislava, Slovakia.
| | - Peter Olejník
- Department of Pediatric Cardiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
- Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases, Children's Cardiac Center, Bratislava, Slovakia
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Ding N, Guo J, Li X, Cao Y, Yi H, Li Z. Kommerell diverticulum, vascular ring, and aberrant left subclavian artery: LSCA translocation or aortopexy. J Pediatr Surg 2021; 56:1757-1763. [PMID: 33678405 DOI: 10.1016/j.jpedsurg.2021.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/16/2020] [Accepted: 02/02/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND/PURPOSE Kommerell diverticulum (KD) in children with right aortic arch and aberrant left subclavian artery can be treated surgically via left subclavian artery (LSCA) translocation or aortopexy. These procedures remain controversial. We compared the outcomes of both procedures. METHODS This retrospective study included 48 patients who underwent LSCA translocation (n = 26) or aortopexy (n = 22). Lateral thoracotomy and sternotomy were performed in 38 and 10 patients with severe intracardiac malformations, respectively. RESULTS The median age of the aortopexy group was 10 months, median follow-up was 14 months, and mean length of hospitalization was 11.41 ± 6.8 days. The median age of the LSCA translocation group was 12 months, median follow-up was 22 months, and mean length of hospitalization was 14.96 ± 7.74 days. Two patients (LSCA translocation group) required secondary intubations and none suffered from recurrent laryngeal nerve injury or complications related to LSCA translocation. Breathing and swallowing symptoms were relieved in all patients. No additional thoracotomies due to respiratory symptoms were required. CONCLUSIONS These two procedures relieve the pressure on the trachea and esophagus with similar short-term outcomes. The long-term outcomes are unknown. LSCA translocation may be the best strategy to prevent symptom recurrence and late complications in these patients. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Nan Ding
- Department of Cardiovascular Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Jian Guo
- Department of Cardiovascular Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xiaofeng Li
- Department of Cardiovascular Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yongli Cao
- Department of Imaging Centre, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Hanlu Yi
- Department of Cardiovascular Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhiqiang Li
- Department of Cardiovascular Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
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He X, Chen J, Li G. Study on the views and methods of ultrasonic screening and diagnosis for abnormal aortic arch in infants. Cardiovasc Ultrasound 2021; 19:8. [PMID: 33446185 PMCID: PMC7809778 DOI: 10.1186/s12947-021-00237-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 01/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to explore echocardiographic views and methods of aortic arch anomalies in infants, so as to improve the screening sensitivity and diagnostic accuracy. METHODS 140 children with abnormal aortic arch diagnosed by ultrasound in Children's Hospital of Hebei Province from January 2014 to December 2019 were selected for retrospective analysis. All were confirmed by surgery or/and computerized tomography angiography. Series of views for aortic arch (the three-vessel and tracheal view, aortic arch short axis view, left aortic arch long axis view, aortic arch long axis continuous scan views) were performed in all cases on the basis of the routine views of echocardiography. The screening sensitivity and diagnostic coincidence rate of different echocardiographic views for aortic arch anomalies were analyzed. RESULTS Among the 140 infants, right aortic arch were 21 cases (6/21 were accompanied by mirror branch and 15/21 were with aberrant left subclavian artery). Left aortic arch with aberrant right subclavian artery were 2 cases, and double aortic arch with both arches open were 20 cases. Double aortic arch with left arch atresia were 2 cases, and atresia of the proximal aorta with aortic arch dysplasia was 1 case. Coarctation of the aorta were 67 cases, and interruption of aortic arch were 27 cases. All the patients were correctly diagnosed except that 2 infants with interruption of aortic arch were incorrectly diagnosed as coarctation of the aorta, and 1 infant with coarctation of the aorta was misdiagnosed as interruption of aortic arch by echocardiography. The screening sensitivities of four views and four-view combination for abnormal aortic arch were 99.3, 73.6, 87.1, 99.3, and 100%; the diagnostic coincidence rates were 85.7, 27.1,66.4, 95.0%, and 97.9% respectively. On the basis of traditional left aortic long axis view, other three views had their own advantages. The screening sensitivity and diagnostic coincidence rate of four-view combination were significantly improved. CONCLUSIONS The three-vessel trachea view is simple and feasible, which is suitable for screening abnormal aortic arch. The combination of four views conduces to improving screening sensitivity and diagnostic accuracy of aortic arch abnormalities.
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Affiliation(s)
- Xinjian He
- Department of Ultrasoud Diagnosis, Children's Hospital of Hebei Province, Hebei Medical University, Shijiazhuang, China.
| | - Jiaoyang Chen
- Department of Ultrasoud Diagnosis, Children's Hospital of Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Gaoyang Li
- Department of Ultrasoud Diagnosis, Children's Hospital of Hebei Province, Hebei Medical University, Shijiazhuang, China
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Nada A, Cousins JP, Ahsan H, Kunin JR. Right aortic arch with mirror image branching pattern and isolated left brachiocephalic artery: A case report. Radiol Case Rep 2020; 15:1786-1791. [PMID: 32793318 PMCID: PMC7413991 DOI: 10.1016/j.radcr.2020.07.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/11/2020] [Accepted: 07/11/2020] [Indexed: 02/05/2023] Open
Abstract
We present a very rare case of right aortic arch with an isolated left brachiocephalic artery in a 35-year-old female. This entity is an extremely uncommon aortic arch anomaly which has associated multisystem symptoms. We briefly discuss the hypothetical double aortic arch model originally described by Edwards. The aortic embryology can explain the anatomic findings and imaging manifestations of the isolated left brachiocephalic artery. Multimodality imaging evaluation can be helpful in detection and categorization of aortic arch abnormalities. A diagnostic imaging approach should focus on elucidating the abnormal aortic arch and great vessels arrangement with determination of associated cardiac, vascular or visceral congenital abnormalities.
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Affiliation(s)
- Ayman Nada
- Department of Radiology, University of Missouri, One Hospital Dr. Columbia, MO, 65212, USA
| | - Joseph P Cousins
- Department of Radiology, University of Missouri, One Hospital Dr. Columbia, MO, 65212, USA
| | - Humera Ahsan
- Department of Radiology, University of Missouri, One Hospital Dr. Columbia, MO, 65212, USA
| | - Jeffrey R Kunin
- Department of Radiology, University of Missouri, One Hospital Dr. Columbia, MO, 65212, USA
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Svetanoff WJ, Zendejas B, Smithers CJ, Prabhu SP, Baird CW, Jennings RW, Hamilton TE. Great vessel anomalies and their impact on the surgical treatment of tracheobronchomalacia. J Pediatr Surg 2020; 55:1302-1308. [PMID: 31422856 DOI: 10.1016/j.jpedsurg.2019.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 07/28/2019] [Accepted: 08/01/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Tracheobronchial compression (TBC) from great vessel anomalies (GVA) can contribute to tracheobronchomalacia (TBM) symptoms. The frequency, impact on symptoms and optimal management of GVA in these patients, with or without a history of esophageal atresia (EA), are still unclear. STUDY DESIGN Patients who underwent surgery for TBM/ TBC between 2001 and 2017 were reviewed. Demographics, type of GVA, and operative interventions were collected. The frequency and treatment modalities of GVA between EA and non-EA patients were compared. RESULTS Overall, 209 patients met criteria; 120 (57.4%) patients had at least one GVA, including double aortic arches (n = 4, 1.9%), right aortic arches (n = 14, 6.7%), aberrant right subclavian arteries (n = 15, 7.2%), and innominate artery compression (n = 71, 34.0%). Non-EA patients were more likely to have surgery later in life (29.5 months versus 16 months, p = 0.0002), double aortic arch (p = 0.0174), right aortic arch (p < 0.0001), and undergo vascular reconstruction concurrently with their airway procedure (25% vs 8.4%, p = 0.002). Vessel reconstruction was performed in 25 patients; six required cardiac bypass. CONCLUSION The frequency of GVA in patients with symptomatic airway collapse is substantial. Multidisciplinary evaluation is imperative for operative planning as many require complex reconstruction and collaboration with cardiac surgery, particularly patients without a history of EA. LEVEL OF EVIDENCE Level III.
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8
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Meliota G, Lombardi M, Zaza P, Tagliente MR, Versacci P, Scalzo G, Vairo U. Isolated persistence of the fifth aortic arch in an infant presenting with congestive heart failure. Ann Pediatr Cardiol 2020; 13:91-94. [PMID: 32030044 PMCID: PMC6979032 DOI: 10.4103/apc.apc_53_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/05/2019] [Accepted: 10/08/2019] [Indexed: 11/12/2022] Open
Abstract
The persistence of the fifth aortic arch (PFAA) in postnatal life is an extremely rare and controversial cardiovascular malformation. PFAA is defined as an extra-pericardial vessel arising from the ascending aorta proximal to the origin of the brachiocephalic arteries, terminating either in the dorsal aorta or in the pulmonary arteries through the persistently patent arterial duct. An isolated PFAA with systemic-to-pulmonary connection best fits this definition, while the vast majority of cases reported as PFAA may have alternative embryological explanations. We present a unique case of a 5-week-old patient with an isolated PFAA with systemic-to-pulmonary connection, who presented with congestive heart failure. A first differential diagnosis was made with distal aortopulmonary window and an atypical patent arterial duct. A careful analysis of the case and a systematic review of the literature made us conclude for an isolated PFAA, which is one of the only five cases ever reported.
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Affiliation(s)
- Giovanni Meliota
- Department of Pediatric Cardiology, Giovanni XXIII Pediatric Hospital, Bari, Italy
| | - Maristella Lombardi
- Department of Pediatric Cardiology, Giovanni XXIII Pediatric Hospital, Bari, Italy
| | - Pierluigi Zaza
- Department of Pediatric Cardiology, Giovanni XXIII Pediatric Hospital, Bari, Italy
| | | | - Paolo Versacci
- Department of Peditarics, Obstetrics and Gynecology, Sapienza - University of Rome, Rome, Italy
| | - Gabriele Scalzo
- Department of Pediatric Cardiology, Giovanni XXIII Pediatric Hospital, Bari, Italy
| | - Ugo Vairo
- Department of Pediatric Cardiology, Giovanni XXIII Pediatric Hospital, Bari, Italy
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Tawfik AM, Sobh DM, Ashamallah GA, Batouty NM. Prevalence and Types of Aortic Arch Variants and Anomalies in Congenital Heart Diseases. Acad Radiol 2019; 26:930-936. [PMID: 30266547 DOI: 10.1016/j.acra.2018.08.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/06/2018] [Accepted: 08/12/2018] [Indexed: 11/30/2022]
Abstract
RATIONALE AND OBJECTIVES Aortic arch (AA) variants and anomalies are important to recognize in patients with congenital heart disease (CHD) before surgery or intervention. The aim was to study the prevalence of AA anomalies and variants in patients with CHD compared to a control group. The secondary outcome was to report the associations between common variations of AA and specific types of CHD. MATERIALS AND METHODS After institutional review board approval, computed tomography studies of 352 CHD patients and control group of 400 consecutive computed tomography scans of the thorax were evaluated. The AA was assigned to one of seven common types, and their distribution was compared between CHD and control. The distribution of the AA anomalies and variants was evaluated as regard specific types of CHD and the visceroatrial situs. RESULTS Normal three-vessel branching pattern was the commonest in both groups, but was present in only 50.5% in the CHD compared to 68.5% in the control group, p < 0.00001. Right AA and aberrant right subclavian artery were significantly more common in CHD than control group (18.1% versus 0.25%, p < 0.00001) and (4.5% versus 0.25%, p = 0.0001), respectively. Direct aortic origin of left vertebral artery was insignificantly more common in CHD group (4.2% versus 2.7%, p = 0.258). Brachiobicephalic trunk was significantly more common in control than CHD group (27.7% versus 19.3%, p = 0.007). CONCLUSION Normal three-vessel AA was significantly less common in CHD. AA anomalies (right arch and aberrant right subclavian) were more common in CHD than control, while AA variants (brachiobicephalic trunk and direct aortic origin of left vertebral artery) were not.
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Affiliation(s)
- Ahmed M Tawfik
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Mansoura University, 12 El-Gomhoreya Street, Mansoura 35112, Egypt.
| | - Donia M Sobh
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Mansoura University, 12 El-Gomhoreya Street, Mansoura 35112, Egypt.
| | - Germeen A Ashamallah
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Mansoura University, 12 El-Gomhoreya Street, Mansoura 35112, Egypt.
| | - Nihal M Batouty
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Mansoura University, 12 El-Gomhoreya Street, Mansoura 35112, Egypt.
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Wang Y, Fan M, Siddiqui FA, Wang M, Sun W, Sun X, Lei W, Zhang Y. Strategies for Accurate Diagnosis of Fetal Aortic Arch Anomalies: Benefits of Three-Dimensional Sonography With Spatiotemporal Image Correlation and a Novel Algorithm for Volume Analysis. J Am Soc Echocardiogr 2018; 31:1238-1251. [PMID: 30146186 DOI: 10.1016/j.echo.2018.07.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Obtaining an accurate diagnosis of fetal aortic arch anomalies is often difficult with traditional two-dimensional (2D) sonography. Thus, the aim of this study was to assess the value of three-dimensional (3D) sonography with spatiotemporal image correlation for diagnosing fetal aortic arch anomalies using a novel algorithm for 3D volume analysis. METHODS Two-dimensional and 3D echocardiographic image data from 300 normal fetuses and 30 fetuses with aortic arch anomalies were retrospectively reviewed. Grayscale and high-definition flow imaging data were available for 2D echocardiography. Three-dimensional volumes were acquired in parasagittal views with high-definition flow imaging information. Volume postprocessing was performed using a novel algorithm to obtain 3D tomographic ultrasound imaging slices and color-rendered images. Detection of aortic arch positions, aberrant brachiocephalic patterns, and aortic arch anomalies was compared for 2D and 3D modalities. Postnatal echocardiography was used as the truth standard in assessing aortic anatomy. RESULTS In total, four cases of double aortic arch, 21 cases of right aortic arch, one case of retroesophageal aortic arch, and four cases of left aortic arch with aberrant right subclavian arteries were included. Inter- and intraobserver agreement were excellent for 2D and 3D modalities. The 3D modality offered better sensitivity and accuracy compared with 2D imaging for the detection of brachiocephalic anomalies (P < .01) and arch anomalies (P < .01) but comparable sensitivity for arch position. There was no difference in specificity for both modalities. CONCLUSIONS The proposed novel algorithm for volume postprocessing ensures that 3D reconstructed images are obtained with high repeatability. The addition of 3D spatiotemporal image correlation to fetal echocardiography may offer a more accurate diagnosis for arch anomalies.
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Affiliation(s)
- Yu Wang
- Department of Sonography, Shengjing Hospital of China Medical University, Heping District, Shenyang, China
| | - Miao Fan
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Faiza Amber Siddiqui
- Department of Entomology, The Pennsylvania State University, University Park, Pennsylvania
| | - Meilian Wang
- Department of Entomology, The Pennsylvania State University, University Park, Pennsylvania; Department of Microbiology and Parasitology, College of Basic Medical Sciences, China Medical University, Heping District, Shenyang, China
| | - Wei Sun
- Department of Sonography, Shengjing Hospital of China Medical University, Heping District, Shenyang, China
| | - Xue Sun
- Department of Sonography, Shengjing Hospital of China Medical University, Heping District, Shenyang, China
| | - Wenjia Lei
- Department of Sonography, Shengjing Hospital of China Medical University, Heping District, Shenyang, China
| | - Ying Zhang
- Department of Sonography, Shengjing Hospital of China Medical University, Heping District, Shenyang, China.
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Dey M, Garg N, Kumar S. An unusual case of interrupted cervical aortic arch associated with long segment coarctation of the descending thoracic aorta. Cardiol Young 2018; 28:592-4. [PMID: 29422111 DOI: 10.1017/S1047951117001913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Interrupted aortic arch is a rare congenital anomaly in newborns and infants and is commonly associated with other cardiovascular anomalies. Here, we report an unusual case of type A interrupted cervical aortic arch associated with long segment coarctation of the descending thoracic aorta. Patent ductus arteriosus reconstituted the descending thoracic aorta. Proximal segments of the left common carotid and left subclavian arteries were atretic. Echocardiography-gated multidetector CT angiography not only identified the type of aortic arch interruption in the neonate but also delineated the exact anatomical details.
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Abstract
We report a case of isolation of the left brachiocephalic artery with the right aortic arch in a 9-year-old male child masquerading as large patent ductus arteriosus with left-to-right shunt. We have emphasized the subtle clinical findings which served as clues to the diagnosis.
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Affiliation(s)
- Gajendra Dubey
- Department of Cardiology, U N Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India
| | - Saurabh Kumar Gupta
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Shyam Sundar Kothari
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
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Türkvatan A, Büyükbayraktar FG, Olçer T, Cumhur T. Congenital anomalies of the aortic arch: evaluation with the use of multidetector computed tomography. Korean J Radiol 2009; 10:176-84. [PMID: 19270864 PMCID: PMC2651449 DOI: 10.3348/kjr.2009.10.2.176] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2008] [Accepted: 08/11/2008] [Indexed: 11/27/2022] Open
Abstract
Congenital anomalies of the aortic arch have clinical importance, as the anomalies may be associated with vascular rings or other congenital cardiovascular diseases. Multidetector computed tomography (MDCT) angiography enables one to display the detailed anatomy of vascular structures and the spatial relationships with adjacent organs; this ability is the greatest advantage of the use of MDCT angiography in comparison to other imaging modalities in the evaluation of the congenital anomalies of the aortic arch. In this review article, we illustrate 16-slice MDCT angiography appearances of congenital anomalies of the aortic arch.
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Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, TürkIye Yüksek Ihtisas Hospital, Ankara, Turkey.
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