Differential diagnosis of vascular structures in relation to upper ascending aorta: The retro-aortic innominate vein

Abstract

The retroaortic course of left innominate vein is a rare entity which can be misinterpreted during echocardiography for other abnormal vascular structures under the arch of aorta. We report the case of a 2 month old infant where the suprasternal window showed 2 vascular structures beneath the aortic arch, one of which was traced to be a retroaortic innominate vein.

Isolated retroaortic innominate vein and right aortic arch: a case report and review of literature

“…[1][2][3] Associated CHDs include tetralogy of Fallot with or without pulmonary atresia, total anomalous pulmonary venous return, coarctation of aorta, truncus arteriosus, interrupted aortic arch, right atrial isomerism, atrial septal defects, ventricular septal defects (VSDs), pulmonary atresia with VSD, double outlet right ventricle with mitral atresia, and hypoplastic left ventricle. 1,2,[4][5][6][7][8] Aortic arch variants or anomalies such as right-sided aortic arch, high cervical arch, or double aortic arch are frequently associated with this venous anomaly. 1,2,6,9,10 Isolated retroaortic innominate vein without any associated CHD as seen in our patient is exceedingly rare with a reported prevalence of 0.02%.…”

Red colour venous flow in the suprasternal view: a red flag sign

“…Usually there is only one vessel visible except aortic arch, which is right pulmonary artery. The differential diagnosis of additional vessels can be aortopulmonary collaterals, patent ductus arteriosus (PDA) arising from aortic arch, VV in TAPVC and retroaortic innominate vein 2. Meticulous echocardiography can be rewarding in differentiation of these structures.…”

Experience with Tetralogy of Fallot Patients in a Tertiary Care Teaching Institute of North India

“…8 and Video 8). 6 Normally, innominate vein passes above the aortic arch and joins the superior vena cava. In 8.5% of patients with TOF, 7 an innominate vein passing below the aortic arch has been reported.…”