Complete interruption of aortic arch diagnosed in adulthood: a case report

Sharma, Abhishek; Neupane, Nirmal Prasad; Dhakal, Prakash; Aryal, Sajiva; Sitaula, Asim; Rajlawot, Kritisha

doi:10.1016/j.radcr.2022.07.084

Cited by 3 publications

(3 citation statements)

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“…The prevalence of interrupted descending aorta (IDA) is approximately 1% of all congenital heart diseases, affecting three per million live births, making it an extremely rare anomaly, and its confluence with other structural anomalies like severe aortic stenosis (AS) and bicuspid aortic valve (BAV) makes it a rare clinical scenario, making it a complex cardiovascular conundrum, as presented in our case. While most cases are diagnosed in infancy or early childhood, very few adult-onset cases have been reported [ 1 ]. In this complex scenario, multiple congenital anomalies converge to create a challenging clinical condition.…”

Section: Introductionmentioning

confidence: 99%

Unraveling the Trio of Interrupted Descending Aorta, Aortic Stenosis, and Bicuspid Aortic Valve: A Complex Cardiovascular Conundrum

Toshniwal,

Agrawal,

Chaturvedi

et al. 2023

Cureus

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Interrupted descending aorta (IDA) is an extremely rare congenital heart defect characterized by a complete loss of connection between the ascending and descending aorta. This condition is typically diagnosed in infancy or early childhood, but there have been very few cases reported in adulthood. Here, we present a unique case of an IDA in a 16-year-old patient with concomitant aortic stenosis (AS) and bicuspid aortic valve (BAV), making it an extremely rare scenario. This case highlights the importance of early diagnosis and appropriate management in patients with an IDA, particularly when in association with other cardiovascular abnormalities.

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Section: Introductionmentioning

confidence: 99%

Unraveling the Trio of Interrupted Descending Aorta, Aortic Stenosis, and Bicuspid Aortic Valve: A Complex Cardiovascular Conundrum

Toshniwal,

Agrawal,

Chaturvedi

et al. 2023

Cureus

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“…This disorder is more common and ca uses 5%-8% of congenital cardiac abnormalities [5].Conversely, IAA denotes a congenital aortic arch deformity wherein the ascendin g and descending aortas do not have a direct physical relationshi p. Unlike CoA, IAA is a real discontinuity phenomeon [6][7][8]. CoA a nd IAA are correlated despite their being two distinct conditions [6].Congenital conditions or total blockage following CoA can resul t in adult aortic arch interruption, particularly in patients with ext ensive lesion regions and protracted disease [9]. Patients with both illnesses need a large amount of collateral circulation to survive, and whether or not enough collateral circulation forms to sustai n distal blood flow determines whether or not a patient may live to adulthood [9].…”

mentioning

confidence: 99%

“…CoA a nd IAA are correlated despite their being two distinct conditions [6].Congenital conditions or total blockage following CoA can resul t in adult aortic arch interruption, particularly in patients with ext ensive lesion regions and protracted disease [9]. Patients with both illnesses need a large amount of collateral circulation to survive, and whether or not enough collateral circulation forms to sustai n distal blood flow determines whether or not a patient may live to adulthood [9]. Most IAA cases are discovered and treated in i nfancy or during the neonatal period, as this stage has a faster r ate of child development, a smaller load on the heart, and bette r surgical treatment outcomes.…”

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confidence: 99%

Off-pump Aortic Arch Interruption Surgery: Anesthetic Management and Outcomes

Wu,

2024

Preprint

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The present article provides an overview of the anesthetic pr ocedure employed during off-pump aortic arch interruption surger y, a cardiovascular operation. The case study involved a 54-year-o ld male patient who was diagnosed with aortic arch interruption and who underwent an off-pump surgical intervention. Anesthesia protocol: The patient fasted and abstained before surgery. In the operating room, anesthesia induction was achieve d using midazolam, esketamine, etomidate, sufentanil, and rocuro nium. Throughout the procedure, anesthesia was maintained using propofol, remifentanil, and sevoflurane, with dosage adjustments made in accordance with the progress of the surgical interventio n. Intraoperative monitoring: Conventional monitoring included E CG, blood pressure, pulse oxygen saturation, end-tidal CO2, bispec tral index, hemodynamic monitoring, and cerebral oxygen saturati on monitoring (rSO2). The patient's mean arterial pressure (MAP) was carefully regulated within the range of 60-80 mmHg, while t he heart rate was maintained between 50-90 beats per minute t o ensure a stable circulatory state. Anesthesia outcome: The patient's vital signs remained stable, with appropriate anesthesia depth. The surgery was successfully completed, and the patient was transferred to the critical care u nit for postoperative observation and treatment. In off-pump aortic arch interruption surgery, maintaining stabl e vital signs and ensuring stable circulation are crucial anesthetic management components. The reported case demonstrated a satis factory anesthesia effect with no significant complications. This ca se highlights the importance of employing reasonable anesthesia methods and monitoring measures for safe and effective patient care.

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