This investigation presents additional evidence for the hemodynamic influence of intracardiac anomalies on the development of the aortic arch, based on measurements of different parts of the great vessels. Criteria are given to define the normal aortic arch and the different anomalies of the aortic arch, such as interruption, atresia, tubular hypoplasia, hypoplasia, abnormal long segment and juxtaductal coarctation. Two types of of malignment venentricular septal defects are described to illustrate how prenatal intracardiac flow disturbances can account for various aortic arch patterns. An explanation is proposed as to how reduced blood flow through the embryonic preductal aorta may contribute to the pathogenesis of all dimensional anomalies of the aortic arch.

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This report demonstrates the program's effectiveness and illustrates the need for additional provider education regarding genetic testing from a payer's perspective.