Turk Kardiyol Dern Ars. Ahead of Print: TKDA-42739 | DOI: 10.5543/tkda.2019.42739
Association of several anomalies of supra-aortic trunks and surgically corrected aortic aneurysm
Paula Guardia Martínez
, leydimar Anmad Shihadeh
, Patricia Barrio Martínez
Department of Cardiology, Monteprincipe Hospital, Madrid, Spain.
A 70-year-old female with an ascending aortic aneurysm (58 mm) replaced with a prosthetic tube. The computed tomography (CT) identified an altered origin of the supra-aortic trunks (SATs); it showed an independent origin of 5 supra-aortic vessels in the following order (from proximal to distal aorta): right common carotid, (from which the right vertebral artery arises abnormally), left common carotid, left vertebral artery, left subclavian artery and right subclavian artery. The latter showed an abnormal path (Figure1, video 1). This case is striking because several anomalies in the origin and path of the SATs occurred together with the aortic aneurysm.Keywords:
Aberrant right subclavian artery (ARSA), is the most common anomaly of the SATs; its origin is an altered regression of the embryological right IV branchial arch. This condition is usually asymptomatic and it is one of the anomalies known as incomplete vascular rings or slings if occurs when symptoms of tracheal or esophageal compression appear. It arises individually as the last aortic vessel, following a retroesophageal course. It is associated to chromosomal disorders such as Down Syndrome and is more prevalent in populations with congenital cardiopathy.
The CT has a key role in the study of the thoracic aorta and specifically aortic arch malformations in order to plan surgery, since its presence is decisive for chosing the surgical approach. To this end, cardiovascular CT 3D reconstructions are a valuable help for surgeons.
Aberrant right subclavian artery, aberrant left vertebral artery, supra-aortic trunks anomalies, aneurysm of ascending aorta, aortic arch.
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Corresponding Author: Paula Guardia Martínez, Spain